E J Geller1, J M Wu, M L Jannelli, T V Nguyen, A G Visco. 1. Division of Urogynecology and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7570, USA. egeller@med.unc.edu
Abstract
OBJECTIVE: To determine whether planned route of delivery leads to differences in neonatal morbidity. STUDY DESIGN: Analysis was based on planned route of delivery, not actual route of delivery. A total of 4048 subjects were divided into two groups: planned vaginal delivery and planned cesarean delivery. Primary outcomes were neonatal intensive care unit (NICU) admission, respiratory morbidity and neurologic morbidity. RESULT: There were 3868 planned vaginal and 180 planned cesarean deliveries. Planned vaginal delivery had decreased NICU admission (P<0.0001), oxygen resuscitation (P=0.001) and jaundice (P<0.0001) but increased meconium passage (P<0.0001) and 1 min Apgar <or=5 (P=0.02). After multivariable regression, NICU admission remained lower and meconium passage remained higher in the planned vaginal group. CONCLUSION: Planned vaginal delivery led to more meconium passage and low 1 min Apgar but less NICU admissions, oxygen resuscitation and jaundice. Multicenter trials are needed to assess rare but serious outcomes based on planned route of delivery.
OBJECTIVE: To determine whether planned route of delivery leads to differences in neonatal morbidity. STUDY DESIGN: Analysis was based on planned route of delivery, not actual route of delivery. A total of 4048 subjects were divided into two groups: planned vaginal delivery and planned cesarean delivery. Primary outcomes were neonatal intensive care unit (NICU) admission, respiratory morbidity and neurologic morbidity. RESULT: There were 3868 planned vaginal and 180 planned cesarean deliveries. Planned vaginal delivery had decreased NICU admission (P<0.0001), oxygen resuscitation (P=0.001) and jaundice (P<0.0001) but increased meconium passage (P<0.0001) and 1 min Apgar <or=5 (P=0.02). After multivariable regression, NICU admission remained lower and meconium passage remained higher in the planned vaginal group. CONCLUSION: Planned vaginal delivery led to more meconium passage and low 1 min Apgar but less NICU admissions, oxygen resuscitation and jaundice. Multicenter trials are needed to assess rare but serious outcomes based on planned route of delivery.
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