Delivery and long-term outcome of very low birth weight infants.

The obstetric and the neonatal management of 72 infants weighing less than 1 500 g at birth were evaluated. Sixty per cent of the mothers were delivered by cesarean section. The neonatal mortality (27%) was equal in the cesarean section and the vaginally delivered groups, but intraventricular hemorrhage was a more frequent autopsy finding in the latter group. At follow-up, 88% of all surviving infants are neurologically normal at two years of age. Of the vaginally delivered infants, three suffered from cerebral palsy, but none in the cesarean section group. The present results reveal that an active management including cesarean section in the delivery of very low birth weight infants is justified and leads to a favorable prognosis.