{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:37:39Z","timestamp":1787009859403,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,1]]},"abstract":"\n OBJECTIVE:<\/jats:title>\n To determine the relationship between mode of delivery and serious adverse neonatal outcomes in term, singleton, cephalic neonates.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n A 10-year study of 64,555 term neonates reaching the second stage of labor in a single tertiary obstetric unit from 2000 to 2009. Multiple pregnancies, preterm deliveries (before 37 weeks of gestation), and lethal congenital anomalies were excluded. The primary outcome was the rate of peripartum death by mode of delivery. Secondary outcomes were rates of neonatal encephalopathy, intracranial hemorrhage-related mortality, and the relationship between instrument choice and adverse outcomes. Categorical data were compared using the \u03c7\n 2<\/jats:sup>\n test, with odds ratios (ORs) and 95% confidence intervals included when appropriate.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Compared with neonates delivered by second-stage cesarean, there were no differences in the rates of either peripartum neonatal death (OR 0.42;\n P<\/jats:italic>\n =.37) or neonatal encephalopathy (OR 1.07;\n P<\/jats:italic>\n >.99) after operative vaginal delivery. The rates of neonatal encephalopathy associated with operative vaginal and second-stage cesarean delivery were 4.2 and 3.9 per 1,000 term neonates, respectively. No significant differences in adverse neonatal outcomes were demonstrated between vacuum-assisted and forceps-assisted deliveries, although subanalysis is limited by the small numbers of serious adverse outcomes. The absolute risk of neonatal death secondary to intracranial hemorrhage is 3\u20134 per 10,000 operative vaginal deliveries for both instruments.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Operative vaginal delivery is associated with similar rates of serious neonatal complications compared with cesarean delivery at full dilatation.<\/jats:p>\n <\/jats:sec>\n \n LEVEL OF EVIDENCE:<\/jats:title>\n II<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/aog.0b013e3182749ac9","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T14:40:27Z","timestamp":1444747227000},"page":"122-128","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":79,"title":["Mode of Delivery at Term and Adverse Neonatal Outcomes"],"prefix":"10.1097","volume":"121","author":[{"given":"Colin A.","family":"Walsh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fionnuala M.","family":"McAuliffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-19-20260317","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/S0140-6736(09)61870-5","article-title":". Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08.","volume":"375","author":"Lumbiganon","year":"2010","journal-title":"Lancet"},{"key":"R3-19-20260317","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1111\/j.1471-0528.2005.00732.x","article-title":"Risk factors associated with subaponeurotic hemorrhage in full-term infants exposed to vacuum extraction.","volume":"112","author":"Boo","year":"2005","journal-title":"BJOG"},{"key":"R4-19-20260317","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/01.gco.0000192983.76976.68","article-title":"Head injuries after instrumental vaginal deliveries.","volume":"18","author":"Doumouchtsis","year":"2006","journal-title":"Curr Opin Obstet Gynecol"},{"key":"R5-19-20260317","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1056\/NEJM199912023412301","article-title":"Effect of mode of delivery in nulliparous women on neonatal intracranial injury.","volume":"341","author":"Towner","year":"1999","journal-title":"N Engl J Med"},{"key":"R6-19-20260317","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1097\/AOG.0b013e31823835d3","article-title":"Mode of delivery in nulliparous women and neonatal intracranial injury.","volume":"118","author":"Werner","year":"2011","journal-title":"Obstet Gynecol"},{"key":"R7-19-20260317","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/S0140-6736(01)06341-3","article-title":"Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study.","volume":"358","author":"Murphy","year":"2001","journal-title":"Lancet"},{"key":"R10-19-20260317","first-page":"1","article-title":"Births: final data for 2008.","volume":"59","author":"Martin","year":"2010","journal-title":"Natl Vital Stat Rep"},{"key":"R11-19-20260317","doi-asserted-by":"crossref","first-page":"526.e1e1","DOI":"10.1016\/j.ajog.2007.01.024","article-title":"Variation in the rates of operative delivery in the United States.","volume":"196","author":"Clark","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"R12-19-20260317","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1080\/14767050902769982","article-title":"Impact of mode of delivery on neonatal complications: trends between 1997 and 2005.","volume":"22","author":"Jain","year":"2009","journal-title":"J Matern Fetal Neonatal Med"},{"key":"R13-19-20260317","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/1471-2393-11-85","article-title":". Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomised trial.","volume":"11","author":"Begley","year":"2011","journal-title":"BMC Pregnancy Childbirth"},{"key":"R14-19-20260317","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1523-536X.2007.00205.x","article-title":"Neonatal mortality for primary cesarean and vaginal births to low-risk women: application of an intention-to-treat model.","volume":"35","author":"MacDorman","year":"2008","journal-title":"Birth"},{"key":"R15-19-20260317","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"61","author":"Von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"R17-19-20260317","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/sim.4780040112","article-title":"A Wilcoxon-type test for trend.","volume":"4","author":"Cuzick","year":"1985","journal-title":"Stat Med"},{"key":"R18-19-20260317","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1097\/AOG.0b013e3181f38599","article-title":"Trends over time with commonly performed obstetric and gynecologic inpatient procedures.","volume":"116","author":"Oliphant","year":"2010","journal-title":"Obstet Gynecol"},{"key":"R20-19-20260317","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pediatrneurol.2008.09.019","article-title":"Intracranial hemorrhage in term newborns: management and outcomes.","volume":"40","author":"Gupta","year":"2009","journal-title":"Pediatr Neurol"},{"key":"R21-19-20260317","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1136\/bmj.329.7456.24","article-title":"Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis.","volume":"329","author":"Demissie","year":"2004","journal-title":"BMJ"},{"key":"R22-19-20260317","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ajog.2004.06.035","article-title":". Comparison of instrument-associated and spontaneous obstetric depressed skull fractures in a cohort of 68 neonates.","volume":"192","author":"Dupuis","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"R23-19-20260317","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ejogrb.2011.01.004","article-title":"A cohort study of maternal and neonatal morbidity in relation to use of sequential instruments at operative vaginal delivery.","volume":"56","author":"Murphy","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R24-19-20260317","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1097\/AOG.0b013e3181bbf3be","article-title":". Failedoperative vaginal delivery.","volume":"114","author":"Alexander","year":"2009","journal-title":"Obstet Gynecol"}],"container-title":["Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006250-201301000-00019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:00:20Z","timestamp":1773709220000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006250-201301000-00019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013]]}},"URL":"https:\/\/doi.org\/10.1097\/aog.0b013e3182749ac9","relation":{},"ISSN":["0029-7844"],"issn-type":[{"value":"0029-7844","type":"print"}],"subject":[],"published":{"date-parts":[[2013,1]]}}}