title: Delivery modes and the neonatal outcomes of low birth-weight neonates in a Brazilian reference health center.
abstract: OBJECTIVE
  This study compared the neonatal results of low weight neonates born by cesarean and vaginal delivery.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Maternity of Hospital - Irmandade Santa Casa de Misericórdia de São Paulo, Brazil.
  
  
  METHODS
  The analysis included the neonates born alive, of unique pregnancy, <2000 g from October 1999 to July 2013. To obtain the information about the neonatal period, as well as their Apgar score in the 1st and 5th min of life, a search in the database of a neonatal intensive care unit was performed.
  
  
  RESULTS
  In total, 830 neonates were included as per the study criteria. Of these, 519 (62.5%) were born by cesarean delivery and 311 (37.5%) by vaginal delivery. There was a statistically significant difference in the incidence of neonatal complications, with better results in the neonates born by vaginal delivery, except for the group with neonates <1500 g. In this group, there was a higher incidence of intracranial hemorrhage and death before discharge from the hospital. There was also a higher incidence of respiratory distress syndrome and intraventricular hemorrhage in neonates born by vaginal delivery, in all weight groups. Comparing the Apgar scores, there was a statistically significant difference between the delivery modes, with better results observed in the ones born by vaginal delivery. However, the opposite was observed in the group with neonates <1000 g.
  
  
  CONCLUSIONS
  There was no indication of cesarean delivery benefits in neonates 1000-2000 g. However, the opposite was observed when the neonates were <1000 g.
authors.forename: R
authors.initials: R
authors.lastname: Negrini
authors.forename: C L
authors.initials: CL
authors.lastname: Assef
authors.forename: F Costa
authors.initials: FC
authors.lastname: Da Silva
authors.forename: E
authors.initials: E
authors.lastname: Araujo Júnior
mesh_terms: D001034:Apgar Score; D001938:Brazil; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
keywords: caesarean section; intracranial hemorrhage; low birth weight; respiratory distress syndrome.; vaginal delivery