Severe preeclampsia and the very-low-birth-weight infant. The controversy over delivery mode continues

To compare the effects of labor induction with those of cesarean delivery without labor on neonatal outcome in pregnancies complicated by severe preeclampsia and delivery of very-low-birth-weight infants.

This retrospective study covered 400 singleton, live-born infants who weighed 750-1,500 g at birth and were delivered because of severe preeclampsia. Outcome in infants delivered by cesarean section without labor was compared with that in infants exposed to labor induction.

Of the 400 women with severe preeclampsia who delivered infants between 750 and 1,500 g; 280 (70%) had labor induced, and 120 (30%) delivered without labor. Vaginal delivery was accomplished by 182 (65%) women in the induced group. Apgar scores of < or = 3 at five minutes was more common in the labor-induced group (6% versus 3%, P = .04); however, other neonatal outcomes, including respiratory distress syndrome, ventricular hemorrhage, sepsis, seizures and neonatal death, were similar in the two groups. Data analysis of the induced group did not reveal an association between route of delivery and neonatal outcome. Outcome in both groups was satisfactory at six months.

Induction of labor in women with severe preeclampsia is not harmful to very-low-birth-weight infants and appears to be a safe mode of delivery.