Does the mode of delivery affect neonatal morbidity and mortality in very low-birth-weight infants ?

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Published Apr 3, 2013
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Vol. 91 No. 3 (2013): Issue Mar 2013

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Monia Malek-mellouli
Fethi Ben Amara
Nadia Gallouz
Hamdi Gada
Mourad Klilia
Hédi Reziga

Abstract

Background: Despite the great advances made in neonatal intensive care, one of the greatest challenges in perinatology today, remains the management of very low-birth-weight infants (VLWB).
aim: To evaluate the impact of the mode of delivery on very lowbirth- weight infants’ survival and their outcome.
methods: We performed a retrospective comparative study in the department “B” of gynecology-obstetrics in collaboration with the neonatology department of the same centre during a 12-month period. The study population included mothers giving birth to infants weighing between 500 and 1500 grams, at gestational age > 26 weeks and an Apgar score > 3 at one minute. All included cases were classified according to the way of delivery: vaginal delivery ( Group A) giving birth to neonates of group 1 and cesarean section ( group B) giving birth to neonates in group 2 .
results: The study involved 69 women giving birth to 82 very lowbirth- weight infants. Both groups of parturients were homogeneous and similar in age, parity, prenatal care and gestational age. No statistically significant difference was noticed in terms of morbidity and mortality in the very low-birth-weight infants of the two groups. A higher rate of cesarean sections was noticed in breech presentations (74%).
Conclusion: Systematic cesarean section does not guarantee better outcome for very low-birth-weight infants.

Keywords:

Cesarean section; Vaginal delivery; Neonatal morbidity; Neonatal mortality

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References

  1. Mel ch or J, Ara nguren G, Lopez JA, Avil a M, Fe r na ndez - Ll eb r ez L. Perin ata l outc ome of v ery low bir thwei ght infant s by mo de of deli ver y. Int J Gynecol Obs tet. 19 92; 38:181 - 87.
  2. C hong L H, Gould J B. Survival Ad va ntage As sociat ed With C esa rean De li ve ry i n Very Low B irth Weig ht Ve r tex N eo na tes. Am J Obste t G ynec ol 2005 ; 107:96-10 5.
  3. C arme lo G A, Ginl uc a R, Alt omo r e C, Pa via M. In f luence o f mate rn al and so cia l fact or s as predi ctors of low b irt h weig ht in Ital y. BM C Pub li c He alth 20 07; 7: 199-2 05.
  4. C ha n A , Ro de r D , P r iest K , Este r man A. A p eri na tal p e rspec ti ve on S outh A ust r alia in the 19 80s. Med J Aus t 1 992; 157 :51 5-18.
  5. Mari a B. The preterm de liv e ry. Up da tes i n Gynecol ogy and Obs tetric s. N atio na l College o f F ren ch Gynecol ogist s and Obs tetri c ians. Mic he l Tourn aire Ed 198 6; 333-6 2.
  6. Lub ch en c o LO, Bu tt erfi eld L J, D ela ney BV, G old son E, Ko ops B L, Lazot te DC . Out co me of v ery -low-bir th-wei ght infant s: Does ante pa r tum ve rsus neon a tal ref erral h av e a bette r imp act on m ortality, mo r bidity, or lon g-term ou tcome? Am J Obstet Gyn ecol 1 989; 16 0:5 39-45.
  7. C arayo l M , A lexander S, Go ffinet F, et al ; Com it é Sci en tifique; C om ité d e P il ota ge. Mo de o f deli very a nd term breech presenta ti on i n th e PREMODA c ohort. J G ynec ol Ob stet Biol R ep r od 2 004; 3 3:3 7- 44.
  8. R isk in A, R is kin-M ashi ah S , L usky A , Re ichm an B . Is r ael Neonat al Ne twork. T he r ela ti onsh ip betwe en de liv e ry mod e and m or tality in very low birthweig ht sin glet on ve rte x-present ing i nf an ts . Br J Ob stet Gyn aecol 20 04; 111: 1365 -71.
  9. Hu tso n J M, D r iscoll JM, Fox H E, Driscol l Y, S teir ME. The effe ct of o bst etric ma na ge ment on ne onatal mo rta li ty an d morbi dity for i nfa nts w e ighing 7 00-10 00 grams. A m J of Per inat ol 198 6; 3:2 55-61.
  10. Rijken M, Ve e n S, F r an s J W. Ethi cs o f m aint aini ng ex tremel y p ret erm infa nts. Pedi atr Child H eal th 200 7; 17: 2.
  11. Va n Ham M A , Van Do ngen P W, Mulder J. Maternal con se quences of caesare an sec ti on. A ret r ospect ive study of intra-op erat ive a nd po st op erat ive mat e rn al c omp lications of cesare a n sect ion duri ng a 10 y e ar pe riod. Eur J Ob stet Gyn ecol Re prod Biol 199 7; 74: 1-6 .
  12. Lo ve r r o G , G r eco P, Vimerca ti A, Ni co lar di V, varca cci o- Garofalo G, Se lvagg i L. Ma ternal comp li cat ion s as soci ate d with c e sa r ean secti on. J Perin a t Me d 20 01 ; 29 : 3 22-6.
  13. National institue for clinical excellence .Clinical guide line 13 : caesare an section . National I nstitute for clinical ex cellence [www.niceo rg uk/CG01 3NI CE guideli ne] 20 04.
  14. ACGO practice Bulletin. Perinatal care at the threshold of viability. Number 38, September 2002. American college of obstetrics and gynecology. Int J Gynaecol obstet 2002; 79 : 181-8.
  15. ACGO pra ctice bul leti n. Clin ica l managem en t guideli ne s f or o bst etrici an -g ynec olo gis t. N umb er 43, Ma y 20 03. Management o f preterm labo r. Obste t G ynec ol 2003 ; 101: 10 39-47 .
  16. Verl oove-Vanho r ick SP. M an ag eme nt of th e neon ate at the lim it s of viabi li ty: the dut ch v iew poin t. B r J Ob stet Gy na ecol 2 006; 113 : 13-6.
  17. M elchor JC, F ern an de z-Lie bre z L, L inares A , et al. Obs tetri cs variable s pr ed icting su rv ival of immat ur e new born (< 1000 g). R ev Esp Obst G inec 2 : 51, 1989 .
  18. F ourni e A, Des pr ats R. Pra ctical at ti tude to a severe tox emia. Updat es in Gynecol ogy and Obste tri cs . National College o f F r en ch Gynecol ogists a nd Obs tetric ians. Mi ch el To urnaire Ed 198 7; 347 -3 73.
  19. Treisser A, Lel lou c he D, Guerino ni L, Ren a ud R. F e tal hyp otro phy - Scre en ing practic es and attitudes. Up da tes in Gy ne c ol og y an d O bs tetri c s. Nat io nal C ol leg e o f F re nch Gynecologi st s an d Obste trici an s. Michel To urnaire Ed 19 86; 363 - 398.
  20. S a c hs BP, R in ger SA . I nt r a p a r tu m a nd d e li very ro om manag eme nt of the very lo w birth w eight infant . Clin perin atol 16: 8 09,1 989.
  21. Mo ral es WJ, Ko e r ten J. Obst e tri c Man a gem e nt a nd In trav e nt r icu lar He m orrhag e i n Ve r y-Lo w-B irth - We ig ht Infants. Obste t G ynec ol 1986; 68: 35-40 .
  22. Dolfin T, Skidmo r e MB, Fo ng KW, et al . Perin ata l f act ors that i nflu en ce the incid e nc e of s ubependy mal a nd intr av en tri cu lar hem orrhage i n l ow birthwei ght in f an ts. A m J P erinato l 1 984; 1:107 - 13.
  23. Ba cak S, K esha B R, E r ol A, Beli nda I, Te r ry L. Ris k fac tors f or neo na tal mort ality am ong ex tremel y- low-b irth - w eight i nf an ts. Am J Obs tet G ynecol 200 5; 192 :862 - 7.
  24. Deulofe ut R A , B uc hter S , R ah man S, R ogi do M . The Impact of Vaginal D eliv ery in P r ema ture Infants Weighi ng L ess Th an 1, 251 Gra ms. A m J Ob stet Gyn ecol 2 005; 10 5:5 25-531 .
  25. Narayan H, Taylor DJ. Th e role o f caesare an se ctio n in t he delivery o f the very preterm infant . Br J O bst et Gynaec ol 1 994; 10 1:9 36-93 8.