Are active labour and mode of delivery still a challenge for extremely low birth weight infants? Experience at a tertiary care hospital

Vimercati, Antonella; Scioscia, Marco; Nardelli, Claudia; Panella, E.; Laforgia, Nicola; DeCosmo, L.; Selvaggi, Luigi

doi:10.1016/j.ejogrb.2009.04.026

Cited by 11 publications

(13 citation statements)

References 26 publications

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“…None of the pregestational maternal diseases, obstetric complications and mode of delivery proved to be a significant risk factor of neonatal mortality of extreme prematurity in the present study, which was inconsistent with some previous studies [15, 16], but in accordance with others [8, 17]. A 5-min Apgar score ≤3 and infants with at least one major morbidity were the only two independent predictors of neonatal mortality at 7 and 28 days postpartum/discharge in the present study.…”

Section: Discussioncontrasting

confidence: 99%

“…There are conflicting data regarding the outcome of caesarean section in delivering extremely premature infants before 26 weeks’ gestation. Some studies showed that caesarean section was associated with improved neonatal survival and morbidity [4, 26], while others failed to show any survival benefit [17, 27]. Mukhopadhyay et al [27] showed that the survival rates for newborns delivered by caesarean section for fetal reasons before 26 weeks is very poor and suggested that caesarean section before 26 weeks should therefore be performed predominantly for maternal reasons only.…”

Section: Discussionmentioning

confidence: 99%

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Effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme prematurity

Wang

Tanbo

Ellingsen

et al. 2011

Arch Gynecol Obstet

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PurposeTo investigate the effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme preterm deliveries.MethodsRetrospective study of deliveries in a Norwegian tertiary teaching hospital. All women with live births at 24+0– 27+6 weeks of gestation between 2004 and 2007 were included. Major morbidity is defined as intraventricular haemorrhage grade 3–4, periventricular leukomalacia, bronchopulmonary dysplasia or necrotizing enterocolitis. Pregestational maternal, obstetric and perinatal variables were initially compared for mortality and survival with major morbidity at 24-h, 7- or 28-day postpartum/discharge in univariate analysis. Then, a multivariate analysis was conducted in order to determine independent factors associated with mortality and survival with major morbidity.ResultsA total of 109 babies were delivered alive in 92 women, representing 1.6% of total births. The survival rates were 93.6, 84.4 and 80.7%, with a prevalence of major morbidity among survivors of 40.4, 32.1 and 39.4% at 24-h, 7- and 30-day postpartum/discharge, respectively. After adjustment using multiple logistic regression, only a 5-min Apgar score ≤3 and babies with at least one major morbidity had significantly independent effects on neonatal survival. Multiple pregnancy and gestational age <26 weeks were the only two independent risk factors for survival with major morbidity.ConclusionsNeonatal survival was significantly predicted by a 5-min Apgar score and neonatal morbidity, independent of pregestational maternal disease, obstetric complications, method of delivery, gestational age and birth weight in extreme preterm deliveries. The excess morbidity rate was confined among multiples and babies who were delivered before 26 weeks of gestation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme prematurity

Wang

Tanbo

Ellingsen

et al. 2011

Arch Gynecol Obstet

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“…Barrett et al (30) reported that in twin babies with cephalic presentation at [32][33][34][35][36][37][38] +6 GW, a scheduled cesarean section has no effect on neonatal mortality and severe morbidity.…”

Section: Twin Pregnancy and Mortalitymentioning

confidence: 99%

“…In a single-center, retrospective study conducted in Italy, it was emphasized that in the assessment performed on the 18-monthold babies (n=84) at <28 GW (40% of which were at <25 GW), cesarean section did not cause any improvement in terms of neurodevelopmental symptoms (37).…”

Section: Neurodevelopmental Prognosismentioning

confidence: 99%

How are Premature Babies Born?

Uslu¹,

Bülbül²

2016

JAREM

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The best method of delivering the preterm fetus has not been established, and there is controversy on the preferred mode of delivery (vaginal delivery versus cesarean section). However, over the past few decades, there has been a sharp rise in the cesarean section rate, particularly for premature delivery, all over the world. While the cesarean section is thought to decrease mortality and morbidity and is supposed to be the safer route for the fetus, arguments against the cesarean section can be the increased risk in the rise in cesarean sections, maternal morbidity, risks for future pregnancies, and cost. In this article, the available medical evidence on this clinical paradox is reviewed.

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“…Some studies suggest a reduction in stillbirth rate among periviable infants delivered by cesarean [7,12,17,22]. Other research including prospective studies evaluating long-term outcomes of neonates born at periviable gestational ages attribute little neonatal survival to delivery mode [4,18,20,27,28,30]. Despite these conflicting data, cesarean rates at extreme prematurity have increased dramatically over recent years [2,12,16,17,30].…”

Section: Introductionmentioning

confidence: 99%

Mode of delivery at periviable gestational ages: impact on subsequent reproductive outcomes

Lannon

Guthrie²,

Reed³

et al. 2013

Journal of Perinatal Medicine

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Are active labour and mode of delivery still a challenge for extremely low birth weight infants? Experience at a tertiary care hospital

Cited by 11 publications

References 26 publications

Effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme prematurity

Effect of pregestational maternal, obstetric and perinatal factors on neonatal outcome in extreme prematurity

How are Premature Babies Born?

Mode of delivery at periviable gestational ages: impact on subsequent reproductive outcomes

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