Effects of mode of delivery on mortality and severe brain injury in extremely low birth weight infants in Arkansas.

The optimal mode of delivery for extremely low birth weight (ELBW) infants remains unknown. We reviewed the medical records of 374 ELBW infants (gestational age 23-34 weeks) delivered between 1998 and 2003 at UAMS. The cesarean section rate was 63.9%. The overall mortality rate was 16.0%. The mortality rate for vaginally delivered infants was 26.7% (36/135) vs. 10% (24/239) for cesarean section (P < .0001). Cesarean delivery was associated with higher odds of survival without severe brain injury (SBI) (OR = 2.33, 95% CI [1.36, 4.00]).