Severe maternal morbidity in preterm cesarean delivery: A systematic review and meta-analysis

Objective More than half of extremely preterm infants are delivered by cesarean section. Few data available about severe maternal morbidity (SMM) these cesarean. The objective was to determine whether gestational age under 26 weeks gestation (weeks) associated with an increased risk SMM compared between and 34 in women having a delivery. Material methods We searched MEDLINE, ISI Web Science, the Cochrane Database, PROSPERO, ClinicalTrials.gov on January 31, 2020. search strategy clustered terms describing No restrictions language, publication status, study design were applied. Abstracts included if there sufficient information assess quality. authors all identified studies contacted request for aggregated data. Relative risks (RR) calculated using inverse variance method. primary outcome as defined each study. analyzed deliveries 22 weeks. protocol registered PROSPERO (registration: CRD42019128644). Results Six involving 45,572 (3,440 delivering < weeks; 42,132 weeks) included. occurred 607 (17.6 %) 4,483 (10.6 Gestational (RR, 1.65; 95 % CI [Confidence Interval], 1.52–1.78; I2 = 40 %). remained subgroup analyses depending type (prospective or retrospective), country (European non-European), high quality A sensitivity analysis showed that 25 also delivery 1.66; CI, 1.50–1.83; 3%). Conclusions Obstetricians neonatologists should be aware