Impact of elective caesarean section on neonatal retrieval in Western Australia during a 12-year period

To determine whether 2006 Australian national guidance to delay elective caesarean section until 39 weeks’ gestation would reduce the need for neonatal retrieval for respiratory compromise following elective caesarean. This is a retrospective cohort study comparing infants born by elective caesarean section who required retrieval for respiratory distress in Western Australia before and after the national guidance (2003–2006 vs. 2008–2014). The proportion of infants born by elective caesarean section who required retrieval for respiratory distress was reduced in the later cohort (0.77% (153/19 780) vs. 0.55% (227/40 875); p = 0.0012). The diagnosis of surfactant-deficient lung disease amongst retrieved infants was also reduced (26% (40/153) vs. 17.4% (40/227); p = 0.04). A reduction in the proportion of elective caesarean sections before 39 weeks in Western Australia was associated with a reduction in retrieval for respiratory compromise related to surfactant deficiency in infants born by elective caesarean section.