The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2016
Safety of vaginal delivery in very low birthweight vertex singletons: a meta-analysis.
СтатьяМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Barzilay Eran, Gadot Yifat, Koren Gideon
Аннотация
OBJECTIVE: The objective of this study is to assess the safety of vaginal delivery in VLBW singletons in the vertex presentation.
METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched for studies on mode of delivery and neonatal outcome in VLBW singletons in the vertex presentation. A total of 28 studies met our inclusion criteria.
RESULTS: Vaginal delivery was not associated with an increase in overall neonatal mortality compared with cesarean delivery (OR 0.87, 95% CI 0.72-1.04). Vaginal delivery was associated with a significant decrease in mortality for the 1250-1500 g birthweight category (OR 0.57, 95% CI 0.36-0.92), while an increase in mortality in the 500-750 g category was not significant (OR 1.5, 95% CI 0.86-2.61). Severe intraventricular hemorrhage (IVH) was not associated with mode of delivery (OR 1.05, 95% CI 0.85-1.29), but the only two high quality study that assessed IVH of all grades found an increase in risk for IVH in vaginal delivery (OR 1.33, 95% CI 1.16-1.51).
CONCLUSIONS: Vaginal delivery does not appear to increase the risk for neonatal mortality. However, current available data on neonatal morbidity are limited. More high-quality studies are needed to assess the association between mode of delivery and neonatal morbidity.
METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched for studies on mode of delivery and neonatal outcome in VLBW singletons in the vertex presentation. A total of 28 studies met our inclusion criteria.
RESULTS: Vaginal delivery was not associated with an increase in overall neonatal mortality compared with cesarean delivery (OR 0.87, 95% CI 0.72-1.04). Vaginal delivery was associated with a significant decrease in mortality for the 1250-1500 g birthweight category (OR 0.57, 95% CI 0.36-0.92), while an increase in mortality in the 500-750 g category was not significant (OR 1.5, 95% CI 0.86-2.61). Severe intraventricular hemorrhage (IVH) was not associated with mode of delivery (OR 1.05, 95% CI 0.85-1.29), but the only two high quality study that assessed IVH of all grades found an increase in risk for IVH in vaginal delivery (OR 1.33, 95% CI 1.16-1.51).
CONCLUSIONS: Vaginal delivery does not appear to increase the risk for neonatal mortality. However, current available data on neonatal morbidity are limited. More high-quality studies are needed to assess the association between mode of delivery and neonatal morbidity.