795: Optimal gestational age for elective repeat cesarean delivery in Hispanics

To perform a population-based study to determine the effect of the Hispanic ethnicity on the risk of prematurity-related complications(PRC) due to elective repeat cesarean delivery(ERCD) between 36-40 weeks. The NCHS-CDC Natality Database for U.S. from 2004-2008 was reviewed. Only states reporting data on ERCD were included in the analysis. Exclusion criteria used were: multiple pregnancy, attempted trial of labor, fetal anomalies, and diabetes and/or hypertensive disorders including eclampsia. The odds ratio (OR) for PRC defined as low Apgar scores (LA), assisted ventilation (AV), admission to neonatal intensive care unit (NICU), surfactant use (SU), antibiotic use (AB) and neonatal seizures (NS), was determined. Forward-stepwise regression analysis standardized for confounders was performed to calculate the adjusted OR (95% CI) of PRC based on gestational age (GA). Cases delivered from 36-40 weeks were studied with 40 weeks as the reference group. A total of 930,421 ERCD were performed in the reporting states in the U.S. between 2004-2008. After exclusions, 396,823 were non-Hispanic whites, and 244,910 were Hispanics (including 236,733 Hispanic whites). For Hispanics overall and Hispanic whites at 38 weeks there was no difference in adjusted OR of most complications compared to reference group. Indeed, lower rates of LA and AB were observed at this GA compared to reference (table 1). For Hispanic blacks, no differences in AV, AB or NICU was seen at 38 weeks versus controls.Tabled 1Adjusted ORs for PRC according to gestational age at delivery in Hispanics* There appears to be accelerated maturity with no increase in most neonatal morbidities by 38 weeks delivery in Hispanics. Indeed delivery at 38 weeks was associated with lower rates of some complications such as low Apgar and antibiotic use compared to non-Hispanic whites at term. Differences in ethnic outcome may be useful in patient counseling regarding ERCD.