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Boys born by forceps and vacuum extraction examined at 18 years of age
Insights
This 18-year study found no significant differences in mortality or morbidity between forceps and vacuum extraction births. However, forceps delivery was associated with higher intelligence scores in adulthood.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Developmental Psychology
Background:
- Instrumental delivery, including forceps and vacuum extraction, is common in obstetrics.
- Long-term outcomes following different modes of instrumental delivery require further investigation.
- Previous studies have yielded mixed results regarding the late effects of forceps versus vacuum extraction.
Purpose of the Study:
- To compare the long-term medical and psychological outcomes of individuals delivered via forceps versus vacuum extraction.
- To assess the impact of specific obstetric maneuvers, such as Kielland's forceps rotation, on late results.
- To evaluate potential differences in intelligence scores between the two delivery groups.
Main Methods:
- An 18-year follow-up study of males born via forceps (n=62) or vacuum extraction (n=38) in 1962-63.
- Comparison of obstetrical data with medical and psychological military draft board examinations.
- Statistical analysis to determine significant differences in mortality, morbidity, and intelligence scores.
Main Results:
- No significant differences in mortality and morbidity rates were observed between the forceps and vacuum extraction groups compared to the general cohort.
- Rotation of the fetal head with Kielland's forceps during midcavity extractions did not negatively impact late results.
- The forceps group exhibited a significantly elevated mean intelligence score, whereas the vacuum extraction group's scores were comparable to the national average.
Conclusions:
- Both forceps and vacuum extraction appear to have similar safety profiles regarding long-term mortality and morbidity.
- Kielland's forceps rotation is a safe technique with no adverse late effects.
- Forceps delivery may be associated with enhanced cognitive outcomes in offspring, warranting further research into the underlying mechanisms.
Abstract:
An 18-year follow-up study was made of 62 males delivered by forceps and 38 by vacuum extraction in 1962-63. The obstetrical data are compared with the medical and psychological military draft board examinations. The mortality and morbidity rates were not significantly different from those of the total cohort of Norwegian conscripts, either in the forceps or in the vacuum group. Rotation of the fetal head with Kielland's forceps in midcavity extractions did not adversely affect the late results. A significantly elevated mean intelligence score was found in the forceps group, while the vacuum group did not differ from the national average.