Mode of delivery and mortality among preterm newborns.

OBJECTIVE

The purpose of our study was to analyze the frequency of preterm deliveries in Obstetrics & Gynecology Clinic, University Clinical Centre of Kosovo, Prishtina (Republic of Kosovo), as well as to assess the survival advantage of premature newborns according to mode of delivery (cesarean section vs. vaginal).

MATERIAL AND METHODS

A cohort of 12,466 deliveries from the year 2002 was studied retrospectively and preterm deliveries were analyzed. Survival advantage until 28 days of life associated with cesarean and vaginal delivery was assessed with regard to birth weights (500-999 g, 1000-1499 g, 1500-1999 g, and 2000-2499 g).

RESULTS

There were 1,135 preterm deliveries which resulted in 1,189 preterm infants (including multiples). The overall cesarean delivery rate in this group was 32.2%. Among preterm newborns with birth weight 500-999 g, 68 children were delivered vaginally and 5 by caesarean section (5.7% and 0.4% of all preterm babies respectively). None of the infants survived. The percentage of children from cesarean deliveries in the other groups was higher: for preterm infants with birth weight 1000-1499 g--3.2%, 1500-1999 g--8.8% and 2000-2499 g--19.8%. A survival advantage associated with cesarean section was observed in neonates with birth weight 1000-1499 g (p < 0.01).

CONCLUSIONS

On the basis of our study it can be concluded that cesarean delivery is associated with a decreased neonatal mortality risk in preterm neonates but only in those with birth weight of 1000-1499 g.