No relationship between mode of delivery and neonatal mortality and neurodevelopment in very low birth weight infants aged two years

作     者：Jia-Jun Zhu Ying-Ying Bao Guo-Lian Zhang Li-Xin Ma Ming-Yuan Wu 

作者机构：Department of NeonatologyWomen's HospitalZhejiang University School of MedicineHangzhou 310006China 

出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)

年 卷 期：2014年第10卷第3期

页      面：227-231页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：supported by grants from Health Bureau of Zhejiang Province(2012KYA118),Depar tment of Educat ion of Zhejiang Province(Y201328892) Public Technology Research Program of Zhejiang Province(2013C33150) 

主　　题：cesarean delivery neonatal mortality neurodevelopment outcomes vaginal delivery very low birth weight 

摘      要：Background:To compare neonatal mortality and neurodevelopmental outcomes at two years of age in very low birth weight infants(≤1500 g)born by cesarean with those by vaginal ***:In this retrospective,case-control study,we evaluated neonatal mortality,medical conditions and neurodevelopmental outcomes at two years of corrected age in 710 very low birth weight(VLBW)infants born between January 2005 and December *** the 710 infants,351 were born by the cesarean and 359/710 by vaginal ***:There were no significant differences in neonatal mortality between the cesarean delivery group and vaginal delivery group[56/351(15.9%)vs.71/359(19.8%),P=0.20].VLBW infants delivered by the cesarean procedure had a higher incidence of respiratory distress syndrome than those born by the vaginal route[221/351(63.0%)vs.178/359(49.6%),P0.001].There were no differences in other neonatal morbidities,including intraventricular hemorrhage[126/351(35.9%)vs.134/359(37.3%),P=0.69],bronchopulmonary dysplasia[39/351(11%)vs.31/359(8.6%),P=0.38]and necrotising enterocolitis[40/351(11.4%)vs.32/359(8.9%),P=0.32]between the two *** incidence of poor neurodevelopment after cesarean delivery was similar to that after vaginal delivery[105/351(29.9)vs.104/359(29.0%),P=0.78].Conclusions:In neither neurodevelopment nor neonatal mortality did cesarean birth offered significant advantages to VLBW ***,the operation might be associated with an increased risk of respiratory distress syndrome for VLBW *** mode of delivery of VLBW infants should be largely based on obstetric indications and maternal considerations rather than perceived better outcomes for the neonate.