Neonatal respiratory morbidity is halved, but they may be harmful in the long term

In recent years the caesarean section rate in developed countries has been rising. This may be because improved techniques to control haemorrhage, infection, and thromboembolism have increased the safety of the procedure. As a result obstetricians and pregnant women have a reduced threshold for choosing it. However, although maternal risks have decreased, the effects on the baby of surgical delivery before the due date continue to be debated.'

In this issue (p 662), Stutchfield et al confirm previous reports that elective caesarean section before 40 weeks' gestation increases neonatal admissions to the special care unit for respiratory distress (mainly for transient tachypnoea of the newborn).12 In the control group of the randomised controlled trial, 11.4% were admitted at 37 weeks, 6.2% at 38 weeks, and 1.5% at 39 weeks. If women were given two intramuscular injections of 12 mg of betamethasone in the …