Mode of delivery and pregnancy outcomes in preterm birth
To assess the association of mode of delivery and pregnancy outcomes in preterm birth. This is a secondary analysis of Thai database of the World Health Organization Multi-country Survey. We included 880 women with singleton neonates who delivered between 22 and <37 weeks of gestation from 12 hospitals in Thailand. We used multilevel logistic regression to assess the association between mode of delivery and pregnancy outcomes in singleton preterm births, including maternal intensive care unit (MICU) admission, maternal near miss, maternal death; Apgar score <7 at 5 minutes, neonatal intensive care unit (NICU) admission, fresh stillbirth, early neonatal, and perinatal death. All analysis were performed by R program. The prevalence of women delivered by Caesarean Section (CS) was 34.7%. There was only one maternal death and this case was observed in vaginal birth group; only two women delivered by CS were admitted to MICU. CS was associated with significantly increased odds of maternal near miss (adjusted odds ratio (aOR): 12.0; 95% confidence interval (CI): 1.6-87.4), NICU admission (aOR: 1.8; 95%CI: 1.2-2.9). The odds of Apgar score <7 at 5 minutes (aOR: 1.9; 95%CI: 0.8-4.3), fresh stillbirth (aOR: 0.8; 95%CI: 0.2-2.8), early neonatal death (aOR: 0.6; 95%CI: 0.1-6.3), and perinatal death (aOR: 0.7; 95%CI: 0.1-3.2) were not significantly different between CS and vaginal birth. In preterm birth, CS was associated with increased the odds of maternal near miss, and NICU admissions but not significant different for the odds of Apgar score <7, fresh stillbirth, early neonatal death, and perinatal death.
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