Preemies Can Safely Arrive Both Ways

C section for preemies not necessarily safer than vaginal birth

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When extra tiny ones are arriving early in the world, it's not necessarily safer for them to be delivered by c-section instead of a vaginal birth.

Delivery by cesarean has been one way doctors have tried to improve the health of newborns born more than six weeks before their due date and weighing less than the 10th percentile at birth.

"Discuss with your OB/GYN the safest birth options."

But premature babies with a rare condition called intrauterine growth restriction may have fewer complications in vaginal deliveries compared to cesarean deliveries.

The study, led by Dr. Erika Werner of the Gynecology and Obstetrics department at Johns Hopkins University, used New York City birth data from 1995 to 2003 and compared it to hospital discharge records.

The researchers looked at 2,560 undersized infants born between 25 and 34 weeks; 46 percent were delivered vaginally, and 54 percent by c-section.

Werner's team found no significant differences between the two forms of delivery in terms of seizures, sepsis, hemorrhaging or similar birthing complications.

Babies born by c-section were more likely to experience breathing difficulties, even after controlling for the mother's age, ethnicity, education, pre-pregnancy weight, insurance status, the pregnancy week she delivered and whether she had diabetes or high blood pressure.

Compared to the 23 percent of vaginally born babies who experienced breathing problems, 31 percent of those born by c-section had respiratory distress.

According to Dr. Kevin Gordon, M.D., an obstetrician and gynecologist from Arlington, Texas, who was not involved with this study, these results are not necessarily that useful to obstetricians.

"This study was not very impressive since very few obstetricians perform cesareans as a neonatal protective maneuver," Gordon told dailyRx. "This study shows no benefit in the cesarean group as compared to the vaginal delivery group."

In the study results, C-section infants also showed a greater risk of having an Apgar score below 7, but this difference was no longer significant after the researchers factored in the above characteristics of the mother.

They excluded babies under 1.1 pounds, babies who required forceps or vacuum assistance for delivery and babies with known birth defects. They also excluded mothers who had previously had a c-section.

The study was presented February 9 at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in Dallas, TX. No information was available regarding the study's funding or financial disclosures of the authors.

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Last Updated:
February 16, 2012