Effect of mode of delivery on outcome of very-low-birthweight infants.

The hospital survival rate was 47% in 111 inborn infants who weighed 501-1000 g and 90% in 211 who weighed 1001-1500 g. The survival rate after caesarean birth was significantly higher than that after vaginal delivery in the 1001-1500 g group but not in the 501-1000 g group. At 2 years of age, 73% of survivors born at 501-1000 g and 85% of those born at 1001-1500 g had no neurological or developmental disability; no significant difference was found between caesarean and vaginal births. The mode of delivery did not significantly affect survival or late outcome of the 192 singleton infants with cephalic presentation. Although the survival rate was not significantly different between infants with breech and cephalic presentations, the former had a significantly higher disability rate. Within the group of 72 singleton infants with breech presentation, the survival rate after caesarean birth was significantly higher than after vaginal delivery in the 1001-1500 g group but not in the 501-1000 g group. No significant difference in late outcome was found between caesarean and vaginal births in this subgroup.