THE EFFECT OF MODE OF DELIVERY ON LONG-TERM OUTCOME OF VERY-LOW-BIRTH-WEIGHT INFANTS

A prospective 2-year neurodevelopmental follow-up was carried out on 69 very low birthweight (VLBW) infants (< 1501 g), born in the years 1985-87. The aim of the study was to determine whether there was a long-term advantage to cesarean section in these infants. The incidence of major disability and cognitive ability at 2 years of age were assessed, comparing modes of delivery. Cesarean section was performed in 38 out of 69 (55.1%) of the infants. Major disability was diagnosed in 11/69 (15.9%) of the children, of whom 7/38 (18.4%) were delivered by cesarean section, compared with 4/31 (12.9%) delivered vaginally. The difference, accounting for presentation and multiple birth was not statistically significant. Cognitive ability at 2 years of age was tested using the Mental Development Index (MDI) of the Bayley Scales, and was compared, according to mode of delivery, in 55 of 58 infants without major disability. There was no statistically significant difference between mean +/- S.E. in the MDI of 28 infants delivered by cesarean section (99.7 +/- 7.3) and that of 27 infants delivered vaginally (95.6 +/- 4). In summary, at 2 years of age, no clinically relevant benefit was found for VLBW infants who had been delivered by cesarean section.