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

Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery.

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  • 1Division 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.

[PubMed - indexed for MEDLINE]
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