Yllescas-Medrano E, García-Graullera MG, Fernández-Carrocera LA

Language: Spanish
References: 16
Page: 87-93
PDF size: 91.18 Kb.

ABSTRACT

Background: The perinatal mortality particularly among very low birth weight infants is a health issue in developing countries.
Objective: To determine the impact that mortality and morbidity may have on the very low birth weight infants in an intensive care unit.
Material and Methods: One hundred and fifty five files met the inclusion criteria. The patients were divided into two groups according to the birth weight, less than 1,000 g and over a 1,000 g. The variables included were: birth weight, delivery mode, diagnoses and neonatal death. Odd ratios were calculated.
Results: Birth weight less than 1,000 g, delivery mode, labor and hyperbilirrubinemia were more death related. Morbidity was more related with small for gestational age in first place, follow by hyperbilirrubinemia and membrane hyaline disease, 60% each. Suspected sepsis was found in 47.7 % of the patients while confirmed sepsis was found in 32 patients (20.6%)
Conclusions: Very low birth weight infants are at the highest mortality and morbidity risk no matter the delivery mode. More studies are need in order to rule out the impact of labor and the interruption of it has any impact over mortality and morbidity.

REFERENCES

1. Simpson L. Multiple pregnancy and delivery. N Engl J Med 1996; 335: 441-2.

2. Meirowitz N, Ananth C, Smulian J, Vintzileos A. Effect of labor on infant morbidity and mortality with preterm premature rupture of membranes: United States population–based study. Obstet Gynecol 2001; 97: 494-8.

3. Lockwood C. Predicting premature delivery – no easy task. N Engl J Med 2002; 346: 282-4.

4. Malloy M, Onstad L, Wrigth E. The effect of cesarean delivery on birth outcome in very low birth weight infant. Obstet Gynecol 1991; 77: 498-503.

5. Anderson G, Bada H, Sibai B. The relationship between labor and route of delivery in the preterm infant. Am J Obstet Gynecol 1988; 158: 1382-90.

6. Anderson GD, Bada HS, Shaver DC, Harvey CJ, Korones SB, Wong SP, et al. The effect of cesarean section on intraventricular hemorrhage in the preterm infant. Am J Obstet Gynecol 1992; 166: 1091-101.

7. Novy M, Thomas C, Lees M. Uterine contractility and regional blood flow responses to oxytocin and prostaglandin E2 in pregnant rhesus monkeys. Am J Obstet Gynecol 1975; 122: 419-33.

8. Murphy D, Liebling R, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet 2001; 358: 1203- 07.

9. Feldman G. Prospective risk of stillbirth. Obstet Gynecol 1992; 79: 547-53.

10. Alberman E, Blatchley N, Botting B, Schuman J, Dunn A. Medical causes on stillbirth certificates in England and Wales: distribution and results of hierarchical classifications tested by the office for National Statistics. Br J Obstet Gynaecol 1997; 104: 1043-9.

11. Saunders N, Paterson C. Effect of gestational age on obstetric performance: when is “term” over? Lancet 1991; 338: 1190-2.

12. Kitchen W, Ford G, Doyle L, Richards A, Lissenden J, Pepperell R, Duke J. Cesarean section or vaginal delivery at 24 to 28 weeks gestation: Comparison of survival and neonatal and two year morbidity. Obstet Gynecol 1985; 66: 149-57.

13. Towner D, Castro M, Eby-Wilkens E, Gilbert W. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 1999; 341: 1709-14.

14. Newton E, Haering W, Kennedy J, Herschel M, Cetrulo C, Feingold M. Effect of mode of delivery on morbidity and mortality of Infants at early gestational age. Obstet Gynecol 1986; 67: 507-11.

15. Morrison J, Rennie J, Milton P. Neonatal respiratory morbidity and the mode of delivery at term: influence of timing of elective cesarean section. Br J Obstet Gynecol 1995; 102: 101-6.

16. Shankaran S, Bauer C, Bain R, Wright L, Zachary J. Prenatal and perinatal risk and protective factors for neonatal intracranial hemorrhage. Obstet Gynecol Surv 1996; 51: 654-6.