Are active labour and mode of delivery still a challenge for extremely low birth weight infants? Experience at a tertiary care hospital.
OBJECTIVE
This study was to evaluate the impact of mode of delivery and timing of caesarean section in extremely preterm births, below 28 weeks of gestation, on long-term survival and psychomotor outcomes.


METHODS
This was a single-centre retrospective cohort study of 84 cases of extremely low birth weight infants with complete maternal, obstetrical and neonatological information. Mortality and survival with neurological disabilities at 18 months of life were considered outcome measures.


RESULTS
Forty percent of deliveries were at or less than 25 weeks of gestation and birth weight was <or=500 g in 14% of all infants. The overall survival rate was 54.8% with a prevalence of neuromotor impairment with disability among the survivors of 26.1%. After adjustment using multiple logistic regression, only extreme prematurity (<or=25 weeks) and birth weight below 500 g had significant effects on survival (p<0.05), regardless of mode and timing of delivery.


CONCLUSIONS
Mode of delivery and labour seem not to play a significant role in adverse neonatal outcomes, either mortality or neuro-developmental impairment, in extremely low birth weight infants.
Vimercati
Antonella
A
Department of Gynaecology, Obstetrics and Neonatology, University of Medical Science of Bari, Bari, Italy.
Scioscia
Marco
M
Nardelli
Claudia
C
Panella
Emma
E
Laforgia
Nicola
N
Decosmo
Lucrezia
L
Selvaggi
Luigi E
LE
D001724:Birth Weight; D036861:Delivery, Obstetric; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D007743:Labor, Obstetric; D009422:Nervous System Diseases / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies