TITLE:
Mode of delivery and its associated maternal and neonatal outcomes
AUTHORS:
Aiat Shamsa, Jun Bai, Padmini Raviraj, Rajanishwar Gyaneshwar
KEYWORDS:
Obstetric Delivery; Caesarean Section; Obstetric Extraction; Infant Mortality; Maternal Mortality
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.3 No.3,
May
8,
2013
ABSTRACT: Aim: To determine the association between the mode of
delivery and selected neonatal and maternal morbidities and outcomes in NSW,
during 1998-2008. Methods: This study is a retrospective review of NSW Midwives
Data Collection (MDC) of 981,178 deliveries during 1998-2008. Maternal
condition and neonatal outcomes were compared for different modes of
delivery. Results: The annual rate of caesarean section has steadily
increased from 19% to 31.1% with a mean of 25.9% during the study period. The
risk of neonatal death was higher for forceps-assisted delivery compared to
vacuum-assisted delivery (adjusted odds ratio 0.85%, 95% CI 0.52 - 1.37),
caesarean section (adjusted odds ratio 1.14%, 95% CI 1.01 - 1.3) and normal
vaginal delivery. Operative vaginal delivery and caesarean section had
significantly increased risk for maternal mortality compared to normal
vaginal delivery. Conclusions: There is an association between maternal and
neonatal outcome and mode of delivery. Mothers and babies with normal vaginal
delivery achieved better outcomes in this community. Caesarean section and
operative vaginal delivery are associated with significant maternal and
neonatal risk. Breech vaginal delivery carries a significant neonatal risk.
More future prospective analyses, such as multicentre controlled studies,
should be designed to determine whether and how much the adverse pregnancy
outcomes were caused by unnecessary surgical and operative vaginal delivery.