Optimal Timing Of Elective Cesarean In Women With Multiple Prior Cesareans: A Retrospective Cohort Study

Abstract

The optimal time for cesarean delivery in women with more than two previous caesarean deliveries is crucial in minimizing risks. The present study analyzed women at a specialized hospital in Saudi Arabia who had at least two last cesarean deliveries between 2022 and 2024. Participants were classified into two groups: those at 37-38 weeks and those at 39 weeks and above. Women with multiple gestations or comorbidities were excluded, and outcome analysis was conducted using multiple logistic regression methods. The results show a mean age of 35.1 years for the study population, with most participants falling within the 30- to 40-year age range. Maternal complications were significantly more related to elective cesarean section at 38 weeks than at 39 weeks or later. Neonatal outcomes, including NICU admission and respiratory morbidity, showed a favorable trend from 39+0 to 39+6 weeks, although this was not statistically significant. Emergency delivery before 39 weeks bore the highest neonatal risk. Elective cesarean delivery timing in women with multiple prior cesareans significantly influences both maternal and neonatal outcomes. Scheduling cesarean deliveries at 39 weeks could avert neonatal complications. However, future studies will be paramount to developing finite, evidence-based recommendations for optimal practice.