Delivery modes and pregnancy outcomes of low birth weight infants in China

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Abstract

Objective:

To investigate and analyze the perinatal outcomes of low birth weight (LBW) infants, thereby selecting the appropriate mode and suitable time of delivery to improve the adverse pregnancy outcomes.

Study Design:

A retrospective analysis of 112 441 deliveries (from 39 hospitals of different levels in 14 provinces and autonomous regions in China throughout 2011) were performed in this study to further evaluate the modes of delivery and pregnancy outcomes of LBW infants.

Results:

The rate of cesarean section, stillbirth, neonatal asphyxia and mortality of LBW were significantly higher than those of normal birth weight (NBW) infants (odds ratio, 1.24, 56.56, 57.27 and 10.40 times higher, respectively). Stratified analysis showed that adverse events were reduced with the increase in gestational weeks, especially at 34 to 36+6 weeks. However, LBW infants still had higher risks of adverse events as compared with NBW infants. In particular, full-term LBW babies had a 23.81- and 26.06-fold higher risk of stillbirth and neonatal death as compared with term babies with NBW. In addition, the cesarean delivery rate was 1.24-fold higher for LBW babies than for NBW babies. With an increase in gestational age in LBW infants, the rate of cesarean section was also increased. The rates of stillbirth and neonatal mortality of full-term LBW infants who were delivered via cesarean section (0.5% and 1.0%, respectively) were significantly lower than in the vaginal-delivery group (5.2% and 6.9%, respectively).

Conclusion:

LBW is one of the causes of perinatal death and other adverse pregnancy outcomes and increases the rate of cesarean section. Individualized analysis according to gestational age and intrauterine fetal condition should be performed to extend the gestational age to at least 34 weeks before delivery, cesarean section is a relatively safe mode of delivery, but cannot completely eliminate complications. The key to improving mother and child outcomes is to strengthen pregnancy care and reduce low birth weight infants and premature birth. LBW is one of the causes of adverse pregnancy outcomes in both premature and full-term infants and increases the rate of cesarean section. Individualized analysis of the mode of delivery should be performed to extend the gestational age to 34 weeks and so improve the survival rate.

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Acknowledgements

The 39 participating hospitals included NanFang Hospital of Southern Medical University (Yanhong Yu), Affiliated Obstetrics and Gynecology Hospital of Fudan University (Xiaotian Li), First Affiliated Hospital of Medical College of Xi’an Jiaotong University (Wenli Gou), West China Second University Hospital (Xinghui Liu), Shengjing Hospital of China Medical University (Caixia Liu), the Second Hospital of Jilin University (Yanhui Zhao), Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School (Yimin Dai), Shandong Provincial Hospital (Xietong Wang), First Hospital of Inner Mongolia Medical College (Muge Qi), Cangzhou Central Hospital (Junfeng Zhang), Beijing Friendship Hospital, Capital Medical University (Li Lin), Maternal and Child Health Hospital of Taiyuan, Shanxi Province (Meihua Zhang), and the First Teaching Hospital of Xinjiang Medical University (Qiying Zhu). This project was supported by the Special Research Fund in Nonprofit Health Care Industry of the People’s Republic of China, granted to Weiyuan Zhang (201002013) and the Research Fund for High-level Talented Individuals of Beijing Health Bureau, granted to Weiyuan Zhang (2009-2-11). We would like to submit our manuscript “Delivery modes and pregnancy outcomes of low birth weight infants in China”. All authors have read and approved the submitted manuscript.

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Correspondence to L Fan.

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