Original Article
Journal of Perinatology advance online publication 8 October 2009; doi: 10.1038/jp.2009.150
Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery
E J Geller1, J M Wu2, M L Jannelli1, T V Nguyen1 and A G Visco2
- 1Division of Urogynecology and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 2Division of Urogynecology and Reconstructive Pelvic Surgery, Duke University, Durham, NC, USA
Correspondence: Dr EJ Geller, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, CB #7570, Chapel Hill, NC 27599-7570, USA. E-mail: egeller@med.unc.edu
Received 5 July 2009; Revised 23 August 2009; Accepted 24 August 2009; Published online 8 October 2009.
Abstract
Objective:
To determine whether planned route of delivery leads to differences in neonatal morbidity.
Study Design:
Analysis was based on planned route of delivery, not actual route of delivery. A total of 4048 subjects were divided into two groups: planned vaginal delivery and planned cesarean delivery. Primary outcomes were neonatal intensive care unit (NICU) admission, respiratory morbidity and neurologic morbidity.
Result:
There were 3868 planned vaginal and 180 planned cesarean deliveries. Planned vaginal delivery had decreased NICU admission (P<0.0001), oxygen resuscitation (P=0.001) and jaundice (P<0.0001) but increased meconium passage (P<0.0001) and 1 min Apgar 
5 (P=0.02). After multivariable regression, NICU admission remained lower and meconium passage remained higher in the planned vaginal group.
Conclusion:
Planned vaginal delivery led to more meconium passage and low 1 min Apgar but less NICU admissions, oxygen resuscitation and jaundice. Multicenter trials are needed to assess rare but serious outcomes based on planned route of delivery.
Keywords:
cesarean delivery on maternal request, elective cesarean delivery, planned route of delivery
