Effect of Mode of Delivery on Neonatal Outcomes of Appropriately Grown Preterm Infants
Simarojana N, MD1, Pataradool K, MD2
Affiliation : 1 Department of Obstetrics and Gynecology, Paolo Hospital, Samutprakarn, Thailand 2 Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Objective : To determine the impact of mode of delivery on neonatal outcomes in appropriately grown very to moderately preterm
infants.
Materials and Methods: A retrospective cohort study was performed on 190 singleton pregnant women who gave birth to an
appropriately grown infant at 28+0 to 33+6 weeks of gestation in our institution between 2011 and 2014. The study group (n = 95)
comprised women who had undergone cesarean delivery. The control group (n = 95) included those who had vaginal delivery. Both
groups were matched 1: 1 by gestational age at delivery. Neonatal outcomes were compared between the two groups. Multiple
logistic regression analysis was used to determine the risk of neonatal complications.
Results : Complete data of all 190 women were obtained. According to univariable analysis, cesarean delivery increased the risk of
5-minute Apgar score <7 by threefold (95% confidence interval 1.12 to 8.06) compared to vaginal delivery. The risk remained
significant after controlling for confounding factors (adjusted odds ratio = 4.33; 95% confidence interval 1.16 to 16.13). There were
no significant differences between both groups in terms of respiratory distress, sepsis, intraventricular hemorrhage, seizure and
neonatal death.
Conclusion : In appropriately grown infants who were born at 28+0 to 33+6 weeks of gestation, cesarean delivery did not improve
neonatal outcomes compared to vaginal delivery. On the other hand, it increased the risk of 5-minute Apgar score <7.
Keywords : Modes of delivery, Neonatal complications, Preterm infant
