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Mode of Delivery and Outcomes in Very Low-Birth-Weight Infants in the Vertex Presentation.

Summary of "Mode of Delivery and Outcomes in Very Low-Birth-Weight Infants in the Vertex Presentation."

We sought to determine the relationship between mode of delivery and neonatal outcomes in infants <1500 g in a vertex presentation. This was a retrospective cohort study of singleton, vertex-presenting infants weighing <1500 g in a level III neonatal intensive care unit between July 1993 and July 2006. Infants were divided into vaginal or cesarean delivery, and outcomes were compared with univariable and multivariable analysis. Of the 937 infants that met inclusion criteria, 402 (42.9%) underwent cesarean delivery. After controlling for potential confounding variables, there was no increased odds of death (odds ratio [OR] = 1.6: 95% confidence interval [CI] 0.8 to 3.0), severe intraventricular hemorrhage (IVH; OR = 1.2: 95% CI 0.7 to 1.2), necrotizing enterocolitis (OR = 0.82: 95% CI 0.35 to 1.9), or sepsis (OR = 0.79: 95% CI 0.44 to 13) in the vaginally delivered group compared with the cesarean group. In a post hoc analysis, this study had 80% power to detect an absolute difference in death or severe IVH of 6% between study groups, with an alpha of 0.05. In our population of very low-birth-weight infants, there was no association between mode of delivery and neonatal outcomes.

Affiliation

Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York.

Journal Details

This article was published in the following journal.

Name: American journal of perinatology
ISSN: 1098-8785
Pages:

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Medical and Biotech [MESH] Definitions

An infant having a birth weight of 2500 gm. (5.5 lb.) or less but INFANT, VERY LOW BIRTH WEIGHT is available for infants having a birth weight of 1500 grams (3.3 lb.) or less.

An infant whose weight at birth is less than 1000 grams (2.2 lbs), regardless of gestational age.

An infant whose weight at birth is less than 1500 grams (3.3 lbs), regardless of gestational age.

The position or orientation of the FETUS at near term or during OBSTETRIC LABOR, determined by its relation to the SPINE of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the NECK.

The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms.

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