Perinatal outcome and long-term follow-up of extremely low birth weight infants depending on the mode of delivery

J Matern Fetal Neonatal Med. 2011 Oct;24(10):1235-8. doi: 10.3109/14767058.2011.552990. Epub 2011 Mar 7.

Abstract

Objective: To assess the effect of the mode of delivery (vaginal or cesarean section) on survival, morbidity, and long-term psychomotor development of extremely low birth weight (ELBW) infants.

Methods: A longitudinal observational study including 138 ELBW infants (73 born by c-section and 65 vaginally) was conducted. We analyzed the survival and short-term morbidity. We also studied the long-term neurocognitive and motor development using the McCarthy Scales of Children's Abilities (MSCA).

Results: Mortality was significantly higher in newborns delivered vaginally (49.3%) than those delivered by c-section (23.1%). Newborns delivered vaginally had a higher incidence of retinopathy and peri-intraventricular hemorrhage (P-IVH). Children who died had lower gestational age at birth and lower birth weight. After multivariate analysis only birth weight, gestational age at birth and P-IVH were independently associated to mortality. Regarding the long-term evaluation (MSCA), we observed that children born by c-section had lower incidence of abnormal results.

Conclusions: The mode of delivery does not affect survival. Cesarean section provides lower morbidity and better prognosis for neurodevelopment long-term outcome in ELBW infants.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Child Development
  • Delivery, Obstetric / statistics & numerical data*
  • Female
  • Humans
  • Infant Mortality*
  • Infant, Extremely Low Birth Weight*
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Pregnancy
  • Psychomotor Performance
  • Young Adult