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Outcomes of very low birth weight infants born by vaginal delivery versus cesarean section


1Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital Osijek, Osijek, Croatia

2 School of Medicine, University J. J. Strossmayer Osijek, Osijek, Croatia

3 Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital Zagreb, Zagreb, Croatia

4 School of Medicine, University of Zagreb, Zagreb, Croatia

5 Department of Gynecology and Obstetrics, University Hospital Osijek, Osijek, Croatia

6 Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital Rijeka, Rijeka, Croatia

7 School of Medicine, University of Rijeka, Rijeka, Croatia

DOI: 10.22514/SV142.102018.7 Vol.14,Issue 2,November 2018 pp.46-50

Published: 02 November 2018

*Corresponding Author(s): DARJAN KARDUM E-mail:


The optimal mode of delivery for very low birth weight (VLBW) infants remains controversial. Despite lacking evidence of benefits regarding neonatal outcomes, ce-sarean section delivery is becoming more prevalent, particularly in early gestational ages. In our retrospective, multicentr study data were collected for very low birth weight infants born in two Croa-tian perinatal regions in a 3 – year period (2014. – 2016.). The final cohort consisted of 255 very low birth weight infants. The rate of delivery via cesarean section was 74.1% (189/255) and is one of the high-est reported in the literature so far. Infants born vaginally were born at an lower gesta-tional age, had lower 1- and 5-minute Ap-gar scores, lower birth weights, and prog-nosis as expressed by higher Clinical risk index for babies (CRIB) scores and were more often born following chorioamnio-nitis and had higher mortality rate until 7 days of hospitalization. Univariate logistic regression analysis showed that cesarean section reduced the risk of death before 7 days of life (OR 0.34 95% CI 0.182-0.667). This significance was lost after multivariate analysis. In infants surviving after 7 days of hospitalization, rates of short-term neona-tal morbidity (severe intracranial hemor-rhage, cystic periventricular leukomalacia (cPVL), late-onset sepsis, necrotizing en-terocolitis, kidney injury and retinopathy of prematurity requiring interventions) were not significant when comparing in-fants born vaginally and those born fol-lowing cesarean section.


cesarean section, very low birth weight infants, vaginal delivery

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DARJAN KARDUM,BORIS FILIPOVIĆ GRČIĆ,ANDRIJANA MULLER,SANDRO DESSARDO. Outcomes of very low birth weight infants born by vaginal delivery versus cesarean section. Signa Vitae. 2018. 14(2);46-50.


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