Elective cesarean section and induction and their impact on late preterm births

At all gestational ages, the risks of continuing a pregnancy must be carefully balanced against the risks of delivery and the associated risk of prematurity. This concept is of increasing importance in late preterm pregnancy when medical or obstetric complications frequently warrant delivery and the risk of prematurity persists. Given that morbidity exists for infants born between 34 and 37 weeks gestation, efforts should be focused on minimizing the late preterm birth rate and at improving the outcome of these infants. Published guidelines outlining the appropriate timing of elective induction of labor and elective Cesarean section should be closely followed to avoid unintended iatrogenic prematurity. Research should continue to investigate the etiology of spontaneous preterm deliveries and aim to develop strategies of primary prevention. The incidence and etiology of iatrogenic late preterm birth should also be further investigated and alternative management strategies should be considered. To gain information about the impact of elective delivery on late preterm births, the data collected from birth records should reflect the changing obstetric practices in the United States and be revised to include specific information on elective deliveries.