Lucey et al reported the fate of > 4,000 infants delivered between 1996 and 2000 from the Vermont Oxford database with birth weights 401-500 g and noted that among survivors, 55% were delivered by cesarean section (CS) compared to 5% by SVD. We looked retrospectively at outcomes of VVLBW infants delivered at JCMCH in Johnson City, TN, and treated in our NICU between 1/1994 and 12/2004 (11 years). Table 1 summarizes survival and complications between groups: *p < .05.
A statistically significant difference may be noted in the incidence of maternal preeclampsia and percentage of SGA infants among those delivered by CS. Survival was greater among infants delivered by CS vs VD (71% vs 60%; p < .05); no statistically significant differences noted among groups with regard to major morbidities (hsPDA, IPH, severe IVH, PVL, threshold ROP), suggesting that these morbidities are more associated with events that occur following delivery. Our data suggest an advantage with CS mode of delivery among VVLBW premature infants to enhance survival.
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