Original scientific paper
https://doi.org/10.22514/SV142.102018.7
Outcomes of very low birth weight infants born by vaginal delivery versus cesarean section
DARJAN KARDUM
; Neonatal Intensive Care Unit, Department of Pediatrics University Hospital Osijek J. Huttlera 4, 31000 Osijek School of Medicine University J. J. Strossmayer Osijek, Croatia
BORIS FILIPOVIĆ GRČIĆ
ANDRIJANA MULLER
SANDRO DESSARDO
Abstract
The optimal mode of delivery for very low birth weight (VLBW) infants remains controversial. Despite lacking evidence of benefits regarding neonatal outcomes, cesarean section delivery is becoming more prevalent, particularly in early gestational ages. In our retrospective, multicentr study data were collected for very low birth weight infants born in two Croatian perinatal regions in a 3 – year period (2014. – 2016.). The final cohort consisted of 255 very low birth weight infants. The rate of delivery via cesarean section was 74.1% (189/255) and is one of the highest reported in the literature so far. Infants born vaginally were born at an lower gestational age, had lower 1- and 5-minute Apgar scores, lower birth weights, and prognosis as expressed by higher Clinical risk index for babies (CRIB) scores and were more often born following chorioamnionitis and had higher mortality rate until 7 days of hospitalization. Univariate logistic regression analysis showed that cesarean section reduced the risk of death before 7 days of life (OR 0.34 95% CI 0.182-0.667). This significance was lost after multivariate analysis. In infants surviving after 7 days of hospitalization, rates of short-term neonatal morbidity (severe intracranial hemorrhage, cystic periventricular leukomalacia (cPVL), late-onset sepsis, necrotizing enterocolitis, kidney injury and retinopathy of prematurity requiring interventions) were not significant when comparing infants born vaginally and those born following cesarean section.
Keywords
cesarean section; very low birth weight infants; vaginal delivery
Hrčak ID:
217600
URI
Publication date:
1.11.2018.
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