The effect of type of delivery on neonatal outcome in singleton infants of birth weight of 1,000 g or less
J. M. Barrett, F. H. Boehm and W. K. Vaughn
To evaluate the relationship between management of delivery and neonatal
outcome in singleton neonates with birth weights between 501 and 1,000 g, a
retrospective analysis was performed. In the 54-month period ending June
30, 1981, a total of 109 singleton neonates were born at Vanderbilt
University Hospital, Nashville, Tenn, with birth weights between 501 and
1,000 g, 31 weighing 501 through 750 g, and 78 weighing 751 through 1,000
g. The overall neonatal survival rate was 60%, 39% in the group weighing
501 through 750 g and 69% in the group weighing 751 through 1,000 g. In
terms of morbidity and mortality, there was no difference between neonates
delivered by cesarean section compared with those delivered vaginally. The
only significant factor found relating to neonatal mortality was the
occurrence of labor. In the 17 newborns delivered without occurrence of
labor, the frequency of neonatal death was significantly decreased,
although this difference may be caused by differing risk factors in the
infants delivered without occurrence of labor. When labor was present and
the fetus had a cephalic presentation, cesarean section was not found to be
superior to vaginal delivery in terms of neonatal morbidity or mortality
for neonates of 1,000 g or less.
