Document Detail

Mode of delivery in the preterm gestation and maternal and neonatal outcome.
MedLine Citation:
PMID:  20230325     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine if the mode of delivery in preterm gestations is associated with changes in maternal and neonatal outcome.
METHODS: A retrospective cohort study that included all singleton deliveries occurring after spontaneous onset of labour between 25+0 and 32+6 weeks of gestation. Cases of early preterm delivery were identified from clinical records and classified according to the mode of delivery. The following outcomes were derived for each case and compared between caesarean and vaginal deliveries: perinatal death, cranial findings compatible with haemorrhage or white matter disease in the neonate, new-onset of maternal severe anaemia or pyrexia.
RESULT: From 1990 to 2007, 109 cases of spontaneous preterm labour were retrospectively selected, including 50 (45.8%) caesarean sections and 59 (54.2%) vaginal deliveries. Perinatal death occurred in 10 infants (9.1%), whereas among survivors abnormal cerebral findings were detected in 20, including 6 cases with haemorrhage, 12 with white matter findings and 2 with both. At multiple logistic regression, a birthweight lower than 1100 g was the only predictor of all adverse outcomes, whereas male sex increased the risk of white matter findings. Caesarean section compared to vaginal delivery conferred a higher risk of maternal complications (23/50 or 46% vs. 6/59 or 10.2%; OR: 11.9, CI 95%: 4.2-333; p<0.0005).
CONCLUSIONS: In severely premature infants born after spontaneous onset of labour, the risk of adverse perinatal outcome does not seem to depend upon the mode of delivery, whereas the risk of maternal complications is significantly increased after Caesarean section.
Tullio Ghi; Elisa Maroni; Tiziana Arcangeli; Rosina Alessandroni; Marcello Stella; Aly Youssef; Gianluigi Pilu; Giacomo Faldella; Giuseppe Pelusi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-16
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-11     Completed Date:  2011-02-17     Revised Date:  2014-10-28    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1424-8     Citation Subset:  IM    
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MeSH Terms
Betamethasone / administration & dosage
Birth Weight
Brain Diseases / epidemiology
Cesarean Section
Cohort Studies
Delivery, Obstetric / methods*
Gestational Age
Infant, Newborn
Labor Presentation
Logistic Models
Obstetric Labor, Premature
Perinatal Mortality
Pregnancy Outcome*
Premature Birth*
Retrospective Studies
Sex Factors
Young Adult
Reg. No./Substance:

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