The influence of mode of delivery on neonatal and maternal short and long-term outcomes

OBJECTIVE: To evaluate the impact of mode of delivery on breastfeeding incentive practices and on neonatal and maternal short and long-term complications. METHODS: A cohort study was conducted between June 2015 and April 2016 with 768 puerperal women from 11 maternities in Sergipe, interviewed in the first 24 hours, 45–60 days and 6–8 months after delivery. Associations between breastfeeding incentive practices, neonatal and maternal, both short-term and late complications, and the exposure variables were evaluated by the relative risk (95%CI) and the Fisher exact test. RESULTS: The C-section newborns had less skin-to-skin contact immediately after delivery (intrapartum C-section: 0.18, 95%CI 0.1–0.31 and elective C-section: 0.36, 95%CI 0.27–0.47) and less breastfeeding within one hour of birth (intrapartum C-section: 0.43, 95%CI 0.29–0.63 and elective C-section: 0.44, 95%CI 0.33–0.59). Newborns from elective C-section were less frequently breastfed in the delivery room 0.42 (95%CI 0.2–0.88) and roomed-in less 0.85 (95%CI 0.77–0.95). Women submitted to intrapartum C-section had greater risk of early complications 1.3 (95%CI 1.04–1.64, p = 0.037) and sexual dysfunction 1.68 (95%CI 1.14–2.48, p = 0.027). The frequency of neonatal complications, urinary incontinence and depression according to the mode of delivery was similar. CONCLUSIONS: The C-section was negatively associated with breastfeeding incentive practices; in addition, C-section after labor increased the risk of early maternal complications and sexual dysfunction.