Document Detail


Mode of delivery and neonatal outcomes in preterm, small-for-gestational-age newborns.
MedLine Citation:
PMID:  22914464     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare neonatal outcomes by method of delivery in preterm (34 weeks of gestation or prior), small-for-gestational-age (SGA) newborns in a large diverse cohort.
METHODS: Birth data for 1995-2003 from New York City were linked to hospital discharge data. Data were limited to singleton, liveborn, vertex neonates delivered between 25 and 34 weeks of gestation. Births complicated by known congenital anomalies and birth weight less than 500 g were excluded. Small for gestational age was used as a surrogate for intrauterine growth restriction. Associations between method of delivery and neonatal morbidities were estimated using logistic regression.
RESULTS: Two thousand eight hundred eighty-five SGA neonates meeting study criteria were identified; 42.1% were delivered vaginally, and 57.9% were delivered by cesarean. There was no significant difference in intraventricular hemorrhage, subdural hemorrhage, seizure, or sepsis between the cesarean delivery and vaginal delivery groups. Cesarean delivery compared with vaginal delivery was associated with increased odds of respiratory distress syndrome. The increased odds persisted after controlling for maternal age, parity, ethnicity, education, primary payer, prepregnancy weight, gestational age at delivery, diabetes, and hypertension.
CONCLUSION: Cesarean delivery was not associated with improved neonatal outcomes in preterm SGA newborns and was associated with an increased risk of respiratory distress syndrome.
Authors:
Erika F Werner; David A Savitz; Teresa M Janevic; Robert M Ehsanipoor; Stephen F Thung; Edmund F Funai; Heather S Lipkind
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  120     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-23     Completed Date:  2012-10-29     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  560-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. ewerner4@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Apgar Score
Cesarean Section / adverse effects*,  statistics & numerical data
Delivery, Obstetric / adverse effects,  methods,  statistics & numerical data
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / etiology*,  mortality
Infant, Small for Gestational Age*
Intracranial Hemorrhages / etiology,  mortality
Logistic Models
Odds Ratio
Pregnancy
Respiratory Distress Syndrome, Newborn / etiology,  mortality
Retrospective Studies
Seizures / etiology,  mortality
Sepsis / etiology,  mortality
Grant Support
ID/Acronym/Agency:
R21 HD058111/HD/NICHD NIH HHS
Comments/Corrections
Comment In:
Obstet Gynecol. 2012 Dec;120(6):1479; author reply 1479   [PMID:  23168778 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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