Respiratory distress of the neonate and the rate of caesarean section have increased over the last 30 years. Is there a link

Ces trente dernieres annees, on note en Suisse une augmentation significative de l'incidence du syndrome de detresse respiratoire (SDR) chez le nouveau-ne (NN), touchant particulierement les enfants avec un poids de naissance >2500 g. En meme temps, le taux des cesariennes (CS) s'est aussi accru. Une explication pour une eventuelle correlation entre les deux evolutions est une augmentation en particulier des CS electives qui ont tendance a etre planifiees a un terme precoce pour eviter la mise en travail spontanee. Suite a cela, le foetus est prive de differents mecanismes qui favorisent l'adaptation pulmonaire perinatale. Les benefices reels de la CS sur la morbidite tant foetale que maternelle ne doivent pas faire oublier que la CS est un facteur de risque pour le SDR du NN. Ce risque peut etre diminue efficacement en planifiant une CS elective apres 39 semaines revolues. In Switzerland, the rate of respiratory distress in neonates needing hospitalization has doubled over the last thirty years, concerning in particular babies weighing more than 2500 g. In the same time, the rate of Caesarean section (CS) has also multiplied. We suppose that a link between the two evolutions might be the increase of elective CS. They tend to be planned early at term to avoid the onset of spontaneous labour As a consequence, the foetus is deprived of different mechanisms helping pulmonary transition around birth. The potential benefits of CS regarding morbidity of foetus and mother should not overshadow that CS is a significant risk factor for respiratory problems of the neonate. This risk could be dramatically decreased by planning elective CS only after completed 39 weeks of gestation