Neurodevelopmental outcome at 5 years after operative delivery in the second stage of labor: a cohort study

Abstract

Objective: The purpose of this study was to compare the neurodevelopmental outcome of children at 5 years of age after instrument vaginal delivery and cesarean delivery in the second stage of labor.

Study design: This prospective cohort study was comprised of women with term, singleton, cephalic pregnancies who needed operative delivery in the operating room during the second stage of labor from February 1999 to February 2000. Data were collected with postal questionnaires and review of medical records. The primary outcome measure was the neurodevelopment of children at 5 years of age.

Results: A total of 393 women required operative delivery, of whom 264 women (67%) completed questionnaires at 5 years. A total of 66 children (17%) had been born in poor condition (Apgar score <7 at 5 minutes, umbilical artery pH <7.10, significant trauma, sepsis, or special care baby unit admission). Medical records were available for all 66 children. Rates of neurodevelopmental morbidity were low, with no significant differences between delivery groups. Two children had significant neurodevelopmental morbidity, but this was unlikely to relate to the mode of delivery.

Conclusion: In this cohort, the rates of neurodevelopmental morbidity were low overall and comparable, irrespective of the mode of delivery.