[Premature infants delivered by cesarean section before the 32d week of pregnancy]

Sixty-one premature babies delivered by caesarean section (Group C) before the 32nd week of amenorrhoea were compared with 83 control babies (Group T) born by vaginal delivery. The mortality was comparable: 28 and 32.5%, which is statistically more significant in children born before the 28th week of pregnancy (100 and 66% respectively) and weighing less than 1000 g (53 and 57%). Caesarean section improves the prognosis in multiple pregnancies. Morbidity (respiratory troubles, neurological troubles, infections and jaundice) is hardly different in the two groups. Infections in the lungs are less frequent, but broncho-pulmonary dysplasias are more frequent after caesarean section. Sixty-seven per cent of babies in Group C, and 64% in Group T had normal neuro-psychological development. Severe sequellae were found respectively in 9 and 18% of the infants, the difference being due to motor neurone disease of cerebral origin in respectively 0 and 6 cases. Mortality and the sequellae were identical in the two groups in breech presentations. This study does not support extending the indications for caesarean section in pregnancies under 32 weeks.