[The relation between delivery method and prognosis for very low birth weight infants].

Abstract

To further understand the relationship between perinatal factors and prognosis (neonatal and infantile death and major handicaps), we retrospectively studied 128 singletons weighing less than 1,500g (very low birth weight; VLBW) infants, without maternal complications, IUGR or major congenital anomalies. The gestational age (mean +/- SD) at delivery and the birth weight (mean +/- SD) of subjects were 27.1 +/- 2.0 weeks and 1,041.1 +/- 264.1g, respectively. The results of the current study were as follows: 1) Malpresentation, low Apgar score (APS) and Respiratory distress syndrome (RDS) were observed more frequently in non-intact survivors than in intact survivors with statistical significance. Although the occurrence of fetal distress was correlated with low pH in the umbilical artery, no significant correlation was evident between the prognosis and either of the two above mentioned factors. The intact survivors had a significantly high frequency of PROM despite no correlation with signs of infection (WBC, CRP). 2) As to delivery methods in terms of prognosis, a cephalic-vaginal group had the best prognosis and a breech-vaginal group had the worst, with statistical significance. A higher frequency of poor prognosis for infants was found in a malpresentation group with cesarean delivery and cervical dilation of more than 4cm. Thus, vaginal delivery is a possible option in case of cephalic VLBW infants.