Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery

J Perinatol. 2010 Apr;30(4):258-64. doi: 10.1038/jp.2009.150. Epub 2009 Oct 8.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Apgar Score
  • Cesarean Section / adverse effects*
  • Databases, Factual
  • Delivery, Obstetric / adverse effects*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / etiology*
  • Intensive Care Units, Neonatal
  • Odds Ratio
  • Patient Participation
  • Pregnancy
  • Retrospective Studies
  • Young Adult