{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T20:31:58Z","timestamp":1781555518184,"version":"3.54.5"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>\n            Objective\u2003The risk of intraventricular hemorrhage (IVH) and periventricular leukomalacia is associated with low birth weight and gestational age. Caesarean section (CS) may reduce the risk of IVH, although it has been a matter of debate. The aim of this study was to evaluate the influence of the mode of delivery (MOD) on the development of IVH and cystic periventricular leukomalacia (cPVL).<\/jats:p><jats:p>\n            Study Design\u2003We analyzed an initial cohort of 11,023 very low birth weight (VLBW) infants born between January 2010 and December 2019. Infants with major malformations and gestational age &lt;23 weeks and \u226532 weeks were excluded. A final cohort of 8,251 newborns was analyzed. Data was collected from Portuguese National very low birth weight registry. Cases were classified as vaginal delivery (VD) or CS. Outcome was assessed in univariate and logistic regression analyses.<\/jats:p><jats:p>\n            Results\u2003The median gestational age was 29 weeks (IQR 3.3) and the median weight was 1,100\u2009g (IQR 555). The prevalence of IVH was significantly higher in the VD group versus the CS group, across all grading levels:1,144 newborns had grade I IVH (16% VD vs. 14% CS, p &lt;0.01), 706 had grade II IVH (12% VD vs. 7.6% CS, p &lt;0.01), and 777 had grade III IVH (14% VD vs. 7.9% CS, p &lt;0.01). Post-hemorrhagic ventricular dilatation occurred in 457 newborns (8.3% VD vs. 4.6% CS, p &lt;0.01) and 456 newborns had periventricular hemorrhagic infarction (8.4% VD vs. 4.5% CS, p &lt;0.01). There was no association between MOD and cPVL. After applying a logistic regression analysis, including known risk factors for IVH and cPVL, VD was independently associated with an increased risk of IVH (odds ratio [OR] 1.600[1.423\u20131.799], p &lt;0.001) and its complications (OR 1.440[1.195\u20131.735], p &lt;0.001). MOD was not associated with an increased risk of cPVL.<\/jats:p><jats:p>\n            Conclusion\u2003Our study suggests that CS is associated with a reduced risk of IVH and its complications in preterm VLBW infants\u2009&lt;\u200932 weeks of gestational age. A CS should be considered in this group of infants to prevent the development of IVH and its complications.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1815-1842","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T22:55:22Z","timestamp":1649112922000},"page":"1238-1244","source":"Crossref","is-referenced-by-count":15,"title":["Delivery Mode and Neurological Complications in Very Low Birth Weight Infants"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4194-7095","authenticated-orcid":false,"given":"Sara Todo Bom","family":"Costa","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universit\u00e1rio de Lisboa Norte, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Costa","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universit\u00e1rio de Lisboa Norte, Lisboa, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 Mendes","family":"Gra\u00e7a","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universit\u00e1rio de Lisboa Norte, Lisboa, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarida","family":"Abrantes","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universit\u00e1rio de Lisboa Norte, Lisboa, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Pediatria, Faculdade de Medicina, Universidade de Lisboa, 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