Perinatal risk factors and mode of delivery correlated to survival and psychomotor disability in extremely low birth weight infants.

BACKGROUND/AIMS: Extreme preterm birth, <28 weeks of gestation, represents a public health concern with major economic implications, being the leading cause of neonatal mortality and morbidity.

METHODS

A single-centre retrospective cohort study was carried out to assess the role of caesarean section and to identify perinatal factors affecting neonatal survival and psychomotor development in these infants. 57 cases with complete maternal, obstetrical and neonatological information were selected for this study and neurological development was assessed for at least 18 months of life.

RESULTS

Infant survival and neurological morbidity rates were directly and inversely correlated to birth weights and gestational age at birth, respectively. In multivariate analysis only extreme prematurity (<or=25 weeks) and birth weight <500 g were significantly associated with mortality, whereas no factor correlated to neuromotor impairment.

CONCLUSIONS

The management of preterm labour at the limit of viability is always challenging. Knowledge of risk factors associated with obstetrical situations may affect medical management and indeed offer useful information for parent counselling.