Abstract
Objective:
To investigate the association between mode of delivery and outcome for the newborn child.
Design:
Retrospective study with data collected from the Neonatal Intensive Care Unit and the Obstetric department at Oslo University Hospital, Ullevål.
Participants:
All liveborn babies, with gestational age 37 completed weeks or more, delivered at Oslo University Hospital, Ullevål between 1 January 2007 and 31 December 2007, and admitted to the neonatal intensive care unit (NICU). 390 neonates were included.
Main outcome measures:
The diagnoses in the neonates discharge report (ICD10).
Apgar score at 1-5-10 minutes post delivery, duration of stay at NICU, presentation (vertex/breech), mode of delivery, duration of membrane rupture, instrumental delivery, induction of labour.
Results:
6,9 % of all term infants born at OUS, Ullevål was admitted to NICU.
Mode of delivery included 28 elective and 102 emergency cesarean sections, 154 spontaneous vaginal deliveries, and 102 instrumental vaginal deliveries. There were also 4 breech deliveries, we excluded these from the discussion because of the small number. The two most frequent diagnoses regardless of delivery mode were asphyxia and respiratory distress. We found a tendency of increased relative risk (RR) of respiratory distress among the neonates delivered by elective cesarean section, but the RR was not significant, RR 1.65, 95 % KI 0.99 – 2.75. The overall mortality rate was 7 of 390 neonates (17,9 ‰).
Conclusion:
The patients included in our study had a wide variety of diagnoses ranging in severity. A planned cesarean delivery seemed to increase the risk of respiratory distress, but in our study this tendency was not significant. This is most likely because of the small number of patients, as this correlation has been shown in other, larger studies. Infants delivered instrumentally had the highest morbidity. Information about risk factors when the infant is delivered by elective cesarean section should be taken into consideration by mothers requesting caesarean section, and the health care personnel advising them.