The impact of mode of delivery on neonatal outcome in preterm births

Gluck, Ohad; Tairy, Daniel; Bar, Jacob; Barda, Giulia

doi:10.1080/14767058.2019.1627319

Cited by 9 publications

(25 citation statements)

References 17 publications

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“…Similarly, we found nearly half (52%) of the preterm neonates were born by CS. This is consistent with the study conducted by O. Gluck et al where the proportion of preterm cesarean delivery was 53.1% 33 . In contrast, a recent multi-country survey found that the prevalence of women with preterm CS delivery was 36.7% 34 .…”

Section: Discussionsupporting

confidence: 93%

Survival and mortality of preterm neonates in a neonatal intensive care unit in Northern Ethiopia: a retrospective cohort study

Gebreheat

Teame

2022

Sci Rep

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The purpose of this study was to assess the predictors of preterm neonatal survival in a neonatal intensive care unit (NICU). A cohort study was conducted retrospectively on 1017 preterm neonates using medical records from January 2014 through December 2018. The Kaplan–Meier model was used to estimate mean survival time and cumulative survival probability. Furthermore, Multivariable Cox regression analysis was run to identify predictors of preterm neonatal mortality using an adjusted hazard ratio (AHR) at P < 0.05 and 95% confidence interval (CI). During the follow-up period in the NICU, the mean survival time of the preterm neonates was 47 (95% CI (43.19–48.95)) days. Compound presentation (AHR = 2.29, 95% CI (1.23–4.24)), perinatal asphyxia (AHR = 2.83, 95% CI (1.75–4.58)), respiratory distress syndrome (AHR = 3.01, 95% CI (1.80–5.01)), 1-min APGAR score (AHR = 0.78, 95% CI (0.62–0.98)), and birth weight (AHR = 0.32, 95% CI (0.17–0.58)) were found to be significant predictors of time to preterm neonatal mortality. In conclusion, the survival probability of preterm neonates showed a considerable decrement in the first week of life. Fetal presentation, gestational age, birth weight, 1-min APGAR score, perinatal asphyxia and respiratory distress syndrome found as independent predictors of preterm neonatal mortality.

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Section: Discussionsupporting

confidence: 93%

Survival and mortality of preterm neonates in a neonatal intensive care unit in Northern Ethiopia: a retrospective cohort study

Gebreheat

Teame

2022

Sci Rep

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“…15,16 Though the total number of babies included male and female babies almost equal in number there were more perinatal deaths among male babies. [15][16][17] A large group of 67% of women with AN complications was in the age group of 25 years or below. 18,19 The majority and forming 70.4% of the total number of babies born in the study group were AGA babies weighing 2500 gm to 3500 gm, and a very small number were LGA babies.…”

Section: Discussionmentioning

confidence: 99%

Vaginal deliveries in a tertiary centre: a current profile

Christe¹,

Tamilselvi²,

Surya

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: A normal delivery is what every woman wishes to have. The objective of this study was to find out the maternal and neonatal outcome and background characteristics of women delivering vaginally in a tertiary care center in Chennai, South India.Methods: For this one-year study, with power above 80%, Parturition records were selected by computerized random numbers, for a calculated sample size. Salient demographic features such as age, residential background and religion were noted. Details of obstetric history, past and current, delivery and baby details and admission to NICU were analyzed. Acceptance of postpartum contraception was noted.Results: A total of 338 women delivered vaginally. Majority of 63%, were from urban background. Late referrals were 19.2% of women,38.5% women had antenatal complications. Primigravida were 49.7%. Nearly 91.4% of women delivered naturally. Previous pregnancy loss was noted in 14.8%. Term deliveries were in 72% of women, and 2.7% of women delivered twins. Average birth weight among primi was 2.5kg and in multi it was 2.8 kg. There were no maternal deaths. Perinatal deaths of 2.96%, of which 90% were preterm births, and all among babies with birth weight below 1.5 kg.Conclusions: The larger majority of 91.4% of women had natural vaginal delivery. Primigravida were 49.7%, and 63% were from urban background. Antenatal complications, obstetric, medical or other complications were noted in 38.5 % of women. Most often observed complications were Gestational hypertension, Gestational diabetes, and Hypothyroidism. NICU care was required for 18% of babies. Preterm births were16.6%. Perinatal deaths were seen in 2.96% of babies. There were no maternal deaths.

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“…Nine studies provided data on cephalic fetuses, of which three 36,38,49 included only fetuses with cephalic presentation, and six 10,11,33,35,44,48 had extractable data for this presentation. Data on breech fetuses could be extracted from 14 studies [3][4][5]9,10,11,33,34,39,42,[44][45][46][47] , while data for cases with unspecified presentation were provided in nine studies [6][7][8]32,35,37,40,41,43 . Sixteen [3][4][5][6][7][8][9][10][11]33,40,[42][43][44][45]47 studies reported on delivery before 28 weeks and four 6,9,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…There was no significant effect of mode of delivery on survival to discharge (six studies 32,35,38,41,46,48 , n = 9597; OR 1.26 (95% CI, 0.40-4.01); I 2 = 98%, very low quality of evidence) (Figure 4b). Vaginal delivery was associated with increased odds of severe IVH (nine studies 6,32,34,[37][38][39]41,44,48 , n = 10 899; OR 1.29 (95% CI, 1.02-1.63); I 2 = 45%, low quality of evidence) (Figure S23), while there was no significant effect on perinatal mortality, PVL, need for mechanical ventilation, BPD, NEC, retinopathy of prematurity, RDS, CP, sepsis, neonatal composite adverse outcome or neurodevelopmental impairment (Figures S21, S22 and S24-S33).…”

Section: Delivery Between 24 and 32 Weeksmentioning

confidence: 99%

“…Further analysis considering earlier gestational age or presentation was not feasible owing to the small number of studies. 37 Gluck (2021) 6 Presentation not specified Fixed-effects model Random-effects model Heterogeneity: I 2 = 0%, τ 2 = 0, P = 0.70 Blue (2015) 32 Minguez-Milio (2011) 41 Presentation not specified Common-effect model Random-effects model Heterogeneity: I 2 = 97%, τ 2 = 5.9852, P < 0.01 Ehrhardt (2022) 35 Hübner (2016) 38 Wood (2018) 48…”

Section: Sensitivity Analysismentioning

confidence: 99%

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Effect of mode of delivery on perinatal outcome in severe preterm birth: systematic review and meta‐analysis

Demertzidou

Chatzakis

Cavoretto

et al. 2023

Ultrasound in Obstet & Gyne

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ObjectiveTo review the evidence on the effect of the mode of delivery on perinatal outcomes of fetuses born before 32 gestational weeks (GW).MethodsMEDLINE, Scopus, Cochrane Central Register of Controlled Trials (Central), the US Registry of clinical trials (www.ClinicalTrials.gov) and grey literature sources were searched, starting from the year 2000, to reflect contemporary practice in perinatal care. Non‐randomized trials that included singleton fetuses, without chromosomal abnormality or major congenital defects, and were born either vaginally or via cesarean delivery, were included in the analysis. Primary outcomes were neonatal death, defined as death in the first 28 days of life, and survival at discharge. Secondary outcomes were other adverse perinatal outcomes. ROBINS‐I tool was used to assess the risk of bias. The overall quality of the evidence for the outcomes was assessed per GRADE. Summary odds ratios (ORs) with 95% confidence intervals (CI) were calculated, and random effects models were used for data synthesis. Subgroup analyses were performed for births before 28 gestational weeks, and births between 28 and 32 gestational weeks, and according to presentation at delivery.Results27 retrospective studies (22317 neonates) were included in the meta‐analysis. All studies reported on singleton pregnancies. Vaginal birth significantly increased the risk of neonatal death (N=1496 neonates) of fetuses born <28w, when all presentations were analyzed (OR 1.87, 95%CI 1.05‐3.35; I2 65%, very low quality), and in breech (N=733) (OR 3.55, 95%CI 2.42‐5.21; I2 21%, moderate quality), while the odds of survival at discharge (N=646) were significantly decreased among the latter as well (OR 0.36, 95%CI 0.24‐0.54; I2 21%, low quality). For breech fetuses born between 28 and 32 gestational weeks, vaginal birth increased the risk of perinatal death (N=1581) (intrapartum and neonatal) (OR 3.06, 95%CI 1.47‐6.35; I2 0%, high quality). In non‐cephalic fetuses born between 24 and 32 gestational weeks, vaginal birth decreases the odds of survival at discharge (N=1068) (OR 0.34, 95%CI 0.22‐0.52; I2 16%, moderate quality).ConclusionThis meta‐analysis suggests that vaginal birth in severe preterm births is associated with an increased risk of neonatal and perinatal death in breech fetuses, while an effect could not be demonstrated in cephalic fetuses.This article is protected by copyright. All rights reserved.

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The impact of mode of delivery on neonatal outcome in preterm births

Cited by 9 publications

References 17 publications

Survival and mortality of preterm neonates in a neonatal intensive care unit in Northern Ethiopia: a retrospective cohort study

Survival and mortality of preterm neonates in a neonatal intensive care unit in Northern Ethiopia: a retrospective cohort study

Vaginal deliveries in a tertiary centre: a current profile

Effect of mode of delivery on perinatal outcome in severe preterm birth: systematic review and meta‐analysis

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