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Comment & Response |

Cesarean Delivery on Maternal Request—Reply

Jeffrey Ecker, MD1
[+] Author Affiliations
1Harvard Medical School, Boston, Massachusetts
JAMA. 2013;310(9):978-979. doi:10.1001/jama.2013.194777.
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In Reply Cesarean delivery on maternal request remains controversial. My article did not have space to discuss every potential effect of CDMR on maternal or neonatal health, but I pointed readers toward more comprehensive reviews such as that conducted for the National Institutes of Health consensus conference.1

Dr Li and colleagues point to emerging evidence of possible long-term effects on pediatric health associated with cesarean delivery. Data for the hygiene hypothesis are limited by the absence of randomized trials and are subject to confounding. As more data emerge and the magnitude of risk becomes more clearly quantified, such outcomes may be part of the conversation between patients and physicians concerning CDMR. How patients weigh these outcomes against the reasons for CDMR will vary among individuals.

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September 4, 2013
Hong-tian Li, MD; Jian-meng Liu, MD, PhD; Jan Blustein, MD, PhD
1Institute of Reproductive and Child Health, Peking University School of Public Health, Beijing, China
2Department of Population Health, New York University School of Medicine, New York
JAMA. 2013;310(9):977-978. doi:10.1001/jama.2013.194750.
September 4, 2013
Marco D. Huesch, MBBS, PhD; Jason N. Doctor, PhD
1Sol Price School of Public Policy, University of Southern California, Los Angeles
2Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles
JAMA. 2013;310(9):978. doi:10.1001/jama.2013.194756.
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