Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jan 22:14:42.
doi: 10.1186/1471-2393-14-42.

Preterm birth by vacuum extraction and neonatal outcome: a population-based cohort study

Katarina Åberg  1 , Mikael Norman, Cecilia Ekéus
Affiliations

Preterm birth by vacuum extraction and neonatal outcome: a population-based cohort study

Katarina Åberg et al. BMC Pregnancy Childbirth. .

Abstract

Background: Very few studies have investigated the neonatal outcomes after vacuum extraction delivery (VE) in the preterm period and the results of these studies are inconclusive. The objective of this study was to describe the use of VE for preterm delivery in Sweden and to compare rates of neonatal complications after preterm delivery by VE to those found after cesarean section during labor (CS) or unassisted vaginal delivery (VD).

Methods: Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010, all live-born, singleton preterm infants in a non-breech presentation at birth, born after onset of labor (either spontaneously, by induction, or by rupture of membranes) by VD, CS, or VE were included, leaving a study population of 40,764 infants. Logistic regression analyses were used to calculate adjusted odds ratios (AOR), using unassisted vaginal delivery as reference group.

Results: VE was used in 5.7% of the preterm deliveries, with lower rates in earlier gestations. Overall, intracranial hemorrhage (ICH) occurred in 1.51%, extracranial hemorrhage (ECH) in 0.64%, and brachial plexus injury in 0.13% of infants. Infants delivered by VE had higher risks for ICH (AOR = 1.84 (95% CI: 1.09-3.12)), ECH (AOR = 4.48 (95% CI: 2.84-7.07)) and brachial plexus injury (AOR = 6.21 (95% CI: 2.22-17.4)), while infants delivered by CS during labor had no increased risk for these complications, as compared to VD.

Conclusion: While rates of neonatal complications after VE are generally low, higher odds ratios for intra- and extracranial hemorrhages and brachial plexus injuries after VE, compared with other modes of delivery, support a continued cautious use of VE for preterm delivery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mode of delivery in relation to gestational age. Figure 1 shows rates (%) of different modes of delivery in relation to gestational age (in completed weeks). The blue, dotted line represents unassisted vaginal deliveries, the red, dashed line represents cesarean sections performed after onset of labor, and the green line represents the vacuum extraction deliveries.
Figure 2
Figure 2
Proportion (%) preterm infants diagnosed with intracranial hemorrhage (ICH) or convulsions by gestational age. Figure 2 shows the proportions (%) of preterm infants diagnosed with ICH and neonatal convulsions in relation to gestational age (in completed weeks). The blue, dotted line represents intracranial hemorrhage (ICH) and the red, dashed line represents neonatal convulsions.
Figure 3
Figure 3
Proportion (%) preterm infants diagnosed with extracranial hemorrhage (ECH), encephalopathy and brachial plexus injury by gestational age. Figure 3 shows the proportions (%) of ECH, encephalopathy (ICD-code P91: other disturbances of cerebral status of newborn), and brachial plexus injury in relation to gestational age (in completed weeks). The blue, dotted line represents extracranial hemorrhage (ECH), the red, dashed line represents encephalopathy and the green line represents brachial plexus injury.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Blencove H, Cousens S, Oestergaard M, Chou D, Moller A-B, Narwal R, Adler A, Garcia CV, Rohde S, Say L, Lawn JE. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379:2162–72. doi: 10.1016/S0140-6736(12)60820-4. - DOI - PubMed
    1. Ghi T, Maroni E, Arcangeli T, Allesandroni R, Stella M, Youssef A, Pilu G, Faldela G, Pelusi G. Mode of delivery in the preterm gestation and maternal and neonatal outcome. J Matern Fetal Neonatal Med. 2010;23(12):1424–1428. doi: 10.3109/14767051003678259. - DOI - PubMed
    1. Högberg U, Holmgren PA. Infant mortality of very preterm infants by mode of delivery, institutional policies and maternal diagnosis. Acta Obstet Gynecol. 2007;86:693–700. doi: 10.1080/00016340701371306. - DOI - PubMed
    1. Werner E, Savitz D, Janevic T, Ehsanipoor R, Thung S, Funai E, Lipkind H. Mode of delivery and neonatal outcomes in preterm, small-for-gestational-age newborns. Obstet Gynecol. 2012;120:560–4. doi: 10.1097/AOG.0b013e318265b16c. - DOI - PMC - PubMed
    1. Drife J. Mode of delivery in the early pretern infant (<28 weeks) BJOG. 2006;113(3):81–85. - PubMed

Publication types

MeSH terms