Impact of mode of delivery on neonatal complications: trends between 1997 and 2005.

OBJECTIVE: This study examined whether rates of selected neonatal complications vary by mode of delivery and whether these rates are changing as a result of the increasing cesarean delivery rate.

METHOD: Birth certificates in New Jersey from 1997 to 2005 were matched to hospital discharge records for mothers and newborns.

RESULTS: In New Jersey, the total cesarean section rate for 2005 was 35.3%, a relative increase of 46% since 1997 (from 24.2%). Rates of transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS), regardless of mode of delivery, increased between 1997 and 2005 from 3.3 to 3.9% and 2.1 to 2.4%, respectively. Newborn injuries declined sharply (from 4.1 to 2.6%), whereas intra-ventricular hemorrhage (IVH) rates remained stable. The rates of RDS, TTN and IVH were highest for cesarean delivery without trial of labor, while the rate of injuries was highest for instrumental vaginal delivery.

CONCLUSION: Neonatal complication rates varied by mode of delivery and decreased with gestational age.