[Effect from surfactant therapy in extremely low birth weight infants depending on the method of delivery]

To look for a correlation between way of delivery and the effect from surfactant therapy with extremely low birth weight infants.

The is a retrospective study and includes babies < or = 1000 g, < or = 28 g.w., born in University Maternity Hospital Maichin dom during the period 2001-2005. Babies were treated with surfactant because of RDS. Babies with severe inborn malformations and those, who died before 28-th day due to severe IVH were excluded from the study. All babies were treated and monitored according to the protocols for surfactant and intensive care therapy. Babies were divided in two groups: group N--33 babies; born by normal delivery, group S--27, born by Cesarean Section.

There are no significant differences between the groups according birth weight, gestational age, gender; severity of RDS, incidence of IUGR; kind of surfactant, timing and number of doses. In both groups there is a slight prevalence of female sex. Incidence of full course corticosteroid prophylactics and of inborn infections is definitely higher in gr. N. Babies were followed for: duration of mechanical ventilation (8 days in gr. S vs 20 in gr. N); duration of O2 therapy (34 days in gr. S vs 55 in gr. N); incidence of IVH: gr. S 74% are IVH grade I-II, 11% are grade III-IV; while in gr. N IVH I-II cm. are 38%, IVH grade III-IV are 56%; incidence of BPD--gr. S 14%, vs gr. N --30%; incidence of rethinopathy--23% in gr. S vs 56% in gr. N; incidence of anaemia--100% in both groups.

With ELBWI treated with surfactant chosing the least traumatic way of delivery is important, ensuring smaller duration of mechanical ventilation and O2 therapy, less severe IVH, BPD and ROP.