Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Clinical Obstetrics

Poster Session 2

(586) Association of Mode of Delivery for Periviable Birth with Neonatal Outcomes

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To determine the association between mode of delivery for periviable infants with neonatal survival and morbidity.

Study Design: Retrospective cohort study using a maternal-infant linked database of live births in the state of Florida from 2006 to 2019. Singleton deliveries of infants born at 22w0d to 25w6d in which neonatal resuscitation was attempted were included.

Results: A total of 6,948 periviable deliveries were identified during the study period. Of those, 2,680 (38.6%) were vaginal births and 4,268 (61.4%) were cesarean births. Those delivering by cesarean were more likely to have medical complications such as hypertension, diabetes, autoimmune disease, preeclampsia, and fetal growth restriction; they were less likely to be in spontaneous labor. Rates of chorioamnionitis were similar between the two groups, as was mean birthweight. Among vaginal deliveries, 14.1% (n=377) of neonates died by 24 hours of life, as compared to 6.3% (n=271) of neonates delivered by cesarean. At one year, 42.5% (n=1,138) of neonates born vaginally had died, as compared to 34.5% (n=1,472) of those born via cesarean. Survival increased with each advancing gestational age week regardless of mode of delivery; however, survival among neonates delivered by cesarean remained higher in each gestational week category. Rates of sepsis, intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, seizures, hypoxic ischemic encephalopathy, asphyxia, hypoxia, acidemia, chest tube placement, and gastric tube placements were similar among the two groups.

Conclusion: Our study indicates improved short- and long-term survival among periviable neonates delivered via cesarean section with similar rates of neonatal morbidity compared to those delivered vaginally. Further study is needed to understand the clinical situations in which cesarean is most likely to improve neonatal outcome in order to balance this against the maternal complications associated with cesarean during the periviable period.