Cesarean birth and neonatal mortality in very low birth weight infants

The authors attempted to relate neonatal mortality to method of delivery in a series of 345 infants, weighing 700 to 1500 g, who were born in King County, Washington, from 1977 to 1979. Overall, 38% of infants delivered vaginally died as opposed to 32% of those with cesarean births. However, after adjustment for birth weight, presentation, and place of delivery, cesarean birth was not associated with reduction in mortality. Even among those infants with a breech presentation, a group believed (on the basis of previous studies) to particularly benefit from cesarean birth, the data failed to show any mortality reduction. Based on the results of this study of very low birth weight singleton infants, it appears that the reduced neonatal mortality associated with cesarean birth, if present at all, is small in magnitude.