Infants born to mothers attempting to deliver vaginally before the 32nd week of pregnancy are as likely to survive as those delivered by a planned cesarean, provided the fetus is in the head-first position, according to a study.
According to the Centers for Disease Control and Prevention, 54% of all infant deaths in the United States occur among the 2% of infants born before the 32nd week of pregnancy.
Some studies have suggested infants delivered vaginally before 32 weeks are less likely to survive through infancy than those delivered by a planned cesarean delivery, and more likely to suffer injury and health effects after passing through the birth canal.
Cesarean delivery, especially in the early preterm period, poses risks for the mother, such as hemorrhage, bladder injury and other complications, the researchers noted. Women who undergo cesarean delivery are at risk of rupturing the uterus during labor and other complications in subsequent pregnancies.
Researchers with the National Institutes of Health compared nearly 3,000 women who attempted to deliver vaginally with those who had delivered by a planned cesarean delivery because of a health risk to the mother or baby that occurred before 32 weeks and required delivery.
Infants in the head-first position were as likely to survive after an attempted vaginal delivery as those delivered by planned cesarean delivery. However, when the fetus was breech, survival rates for deliveries before 32 weeks were considerably higher among infants delivered by planned cesarean delivery, the researchers found.
"The decision to deliver vaginally or by cesarean is an individual one, and must be made carefully by the woman, in close consultation with her physician," Uma M. Reddy, MD, MPH, of the Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the NIH institute where the study was conducted, said in a news release. "Our study provides important information for women who are at risk for early preterm delivery and their physicians to take into account when making their decision.
The researchers analyzed data from the NICHD Consortium on Safe Labor, a long-term study of labor and delivery practices. Nearly 80% of the women with a fetus positioned head-first attempted a vaginal delivery, with a success rate of 84%. The remainder ultimately delivered by cesarean. Of the breech pregnancies, about 30% of women attempted vaginal delivery and, depending on the gestational age, between 17% and 28% percent were successful.
"The next step for our research is to further understand adverse outcomes associated with extremely preterm delivery and to determine what long-term neurological and physical disabilities may be associated with these deliveries," Reddy said.
The study is scheduled for publication in the American Journal of Obstetrics and Gynecology. To read it, visit http://bit.ly/PDSDso.
According to the Centers for Disease Control and Prevention, 54% of all infant deaths in the United States occur among the 2% of infants born before the 32nd week of pregnancy.
Some studies have suggested infants delivered vaginally before 32 weeks are less likely to survive through infancy than those delivered by a planned cesarean delivery, and more likely to suffer injury and health effects after passing through the birth canal.
Cesarean delivery, especially in the early preterm period, poses risks for the mother, such as hemorrhage, bladder injury and other complications, the researchers noted. Women who undergo cesarean delivery are at risk of rupturing the uterus during labor and other complications in subsequent pregnancies.
Researchers with the National Institutes of Health compared nearly 3,000 women who attempted to deliver vaginally with those who had delivered by a planned cesarean delivery because of a health risk to the mother or baby that occurred before 32 weeks and required delivery.
Infants in the head-first position were as likely to survive after an attempted vaginal delivery as those delivered by planned cesarean delivery. However, when the fetus was breech, survival rates for deliveries before 32 weeks were considerably higher among infants delivered by planned cesarean delivery, the researchers found.
"The decision to deliver vaginally or by cesarean is an individual one, and must be made carefully by the woman, in close consultation with her physician," Uma M. Reddy, MD, MPH, of the Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the NIH institute where the study was conducted, said in a news release. "Our study provides important information for women who are at risk for early preterm delivery and their physicians to take into account when making their decision.
The researchers analyzed data from the NICHD Consortium on Safe Labor, a long-term study of labor and delivery practices. Nearly 80% of the women with a fetus positioned head-first attempted a vaginal delivery, with a success rate of 84%. The remainder ultimately delivered by cesarean. Of the breech pregnancies, about 30% of women attempted vaginal delivery and, depending on the gestational age, between 17% and 28% percent were successful.
"The next step for our research is to further understand adverse outcomes associated with extremely preterm delivery and to determine what long-term neurological and physical disabilities may be associated with these deliveries," Reddy said.
The study is scheduled for publication in the American Journal of Obstetrics and Gynecology. To read it, visit http://bit.ly/PDSDso.
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