Details

Autor(en) / Beteiligte

• Huang, Yi‐Ya
• Chang, Jui‐Hsing
• Chen, Chia‐Huei
• Peng, Chun‐Chin
• Hsu, Chyong‐Hsin
• Ko, Mary Hsin‐Ju
• Chen, Chen‐Yu
• Chang, Hung‐Yang
• Tsou, Kuo‐Inn
• Tsao, Po‐Nien
• Mu, Shu‐Chi
• Lien, Reyin
• Lin, Hung‐Chih
• Hsiao, Chien‐Chou
• Huang, Chao‐Ching
• Chen, Chih‐Cheng

Titel

Association of mode of delivery with short‐term and neurodevelopmental outcomes in periviable singleton infants: A nationwide database study

Ist Teil von

• International journal of gynecology and obstetrics, 2023-10, Vol.163 (1), p.307-314

Ort / Verlag

United States

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Wiley Online Library

Beschreibungen/Notizen

• Objective To evaluate the association of mode of delivery (MOD) with short‐term and neurodevelopmental outcomes at 2 years of corrected age (CA) in periviable singleton infants. Methods This retrospective cohort study of the Taiwan Premature Infant Follow‐up Network database between 2010 and 2016 compared non‐anomalous singleton deliveries (cesarean delivery [CD] vs vaginal delivery [VD]) between 22 0/7 and 25 6/7 gestational weeks. Major morbidities, mortality, and neurodevelopmental outcomes were evaluated at 2‐year CA. Results The CD and VD groups included 354 and 472 infants, respectively. The intraventricular hemorrhage (IVH) rate was lower in the CD group (54% vs 66%, P = 0.001), but severe IVH differed non‐significantly between groups (20% vs 26%, P = 0.057). In the small‐for‐gestational age subgroup, CD was associated with lower IVH (56% vs 84%, adjusted odds ratio [aOR] 0.17, 95% confidence interval [CI] 0.04–0.69) and better survival without neurodevelopmental impairment (29% vs 8%, aOR, 6.64, 95% CI 1.02–43.29) after controlling for potential confounders. Conclusion The optimal MOD for periviable singleton birth and its impact are unclear. CD in periviable singleton births is associated with a decreased IVH risk, without improvement in severe IVH, mortality, or neurodevelopment at 2‐year CA. The small‐for‐gestational age subgroup may benefit from CD for better survival without neurodevelopmental impairment. Synopsis Cesarean delivery in periviable singleton small‐for‐gestational‐age births is associated with better survival without neurodevelopmental impairment.