活跃产程和分娩方式对极低出生体重儿来说仍是挑战吗？一家三级护理医院的经验。

Are active labour and mode of delivery still a challenge for extremely low birth weight infants? Experience at a tertiary care hospital.

作者信息

Vimercati Antonella, Scioscia Marco, Nardelli Claudia, Panella Emma, Laforgia Nicola, Decosmo Lucrezia, Selvaggi Luigi E

机构信息

Department of Gynaecology, Obstetrics and Neonatology, University of Medical Science of Bari, Bari, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2009 Aug;145(2):154-7. doi: 10.1016/j.ejogrb.2009.04.026. Epub 2009 May 22.

DOI:10.1016/j.ejogrb.2009.04.026

PMID:19464785

Abstract

OBJECTIVE

This study was to evaluate the impact of mode of delivery and timing of caesarean section in extremely preterm births, below 28 weeks of gestation, on long-term survival and psychomotor outcomes.

STUDY DESIGN

This was a single-centre retrospective cohort study of 84 cases of extremely low birth weight infants with complete maternal, obstetrical and neonatological information. Mortality and survival with neurological disabilities at 18 months of life were considered outcome measures.

RESULTS

Forty percent of deliveries were at or less than 25 weeks of gestation and birth weight was <or=500 g in 14% of all infants. The overall survival rate was 54.8% with a prevalence of neuromotor impairment with disability among the survivors of 26.1%. After adjustment using multiple logistic regression, only extreme prematurity (<or=25 weeks) and birth weight below 500 g had significant effects on survival (p<0.05), regardless of mode and timing of delivery.

CONCLUSIONS

Mode of delivery and labour seem not to play a significant role in adverse neonatal outcomes, either mortality or neuro-developmental impairment, in extremely low birth weight infants.

摘要