{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:20:36Z","timestamp":1787505636316,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["UG1 HD034216"],"award-info":[{"award-number":["UG1 HD034216"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23 HL157618"],"award-info":[{"award-number":["K23 HL157618"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cesarean delivery is the most common mode of delivery among extremely preterm infants but there are insufficient data regarding the best mode of delivery among extremely preterm singletons. The objective of this study was to compare the rate of death or severe neurodevelopmental impairment among extremely preterm singletons by actual mode of delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Observational study using prospectively collected data from 25 US medical centers. We included postnatally\u2010treated singletons with birth weight 401\u20131000\u2009g, gestational age 22\u2009+\u20090\/7\u201326\u2009+\u20096\/7\u2009weeks, without a major birth defect, born 2006\u20132016. Death or severe neurodevelopmental impairment (Bayley Scales of Infant Development\u20103rd edition cognitive composite score&lt;70, cerebral palsy (Gross Motor Function Classification Scale &gt;3), bilateral blindness, or bilateral hearing loss) at 18\u201326\u2009month follow\u2010up were compared by mode of delivery (cesarean, vaginal including vertex or breech) using propensity score analysis to adjust for baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no difference in death or severe neurodevelopmental impairment between cesarean and vaginal (vertex or breech) births (42.4% cesarean vs. 47.2% vaginal; adjusted odds ratio (aOR), 95% confidence intervals (CI); 1.03, 0.91\u20131.17). Both cesarean delivery (26.8% cesarean vs. 51.5% breech vaginal; aOR: 0.71; 95% CI: 0.55\u20130.92) and vertex vaginal delivery (28.5% vertex vaginal vs. 51.5% breech vaginal; aOR: 0.59; 95% CI: 0.45\u20130.76) were associated with lower mortality compared with breech vaginal delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among postnatally\u2010treated extremely preterm singletons, there was no difference in death or severe neurodevelopmental impairment between cesarean or vaginal delivery. Both vertex vaginal and cesarean delivery were associated with lower mortality compared with breech vaginal delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.15028","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T02:40:18Z","timestamp":1733107218000},"page":"408-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Mode of delivery and outcomes among inborn extremely preterm singletons: A cohort study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3218-1024","authenticated-orcid":false,"given":"Colm P.","family":"Travers","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhuly","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences Unit, RTI International  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhik","family":"Das","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences Unit, RTI International  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namasivayam","family":"Ambalavanan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Peralta\u2010Carcelen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Rainbow Babies and Children's Hospital, Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Cosby","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra","family":"Wyckoff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Tita","sequence":"additional","affiliation":[{"name":"Obstetrics &amp; Gynecology Center for Women's Reproductive Health University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar A.","family":"Carlo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics.National Vital Statistics System Natality on CDC WONDER Online Database. Data are from the Natality Records 2016\u20132021 as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed athttp:\/\/wonder.cdc.gov\/natality\u2010expanded\u2010current.html2023."},{"key":"e_1_2_13_3_1","article-title":"Caesarean section versus vaginal delivery for preterm birth in singletons","volume":"2013","author":"Alfirevic Z","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2620"},{"issue":"117","key":"e_1_2_13_5_1","first-page":"1","article-title":"Neonatal mortality by attempted route of delivery in early preterm birth","volume":"207","author":"Reddy UM","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"289","key":"e_1_2_13_6_1","first-page":"1","article-title":"Early preterm breech delivery: is a policy of planned vaginaldelivery associated with increased risk of neonatal death?","volume":"198","author":"Kayem G","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1999.tb08303.x"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.4.659"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1993.tb15263.x"},{"key":"e_1_2_13_10_1","first-page":"550","article-title":"Factors influencing survival and morbidity with very low birth weight delivery","volume":"62","author":"Worthington D","year":"1983","journal-title":"Obstet Gynecol"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2019-318402"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists.Society for maternal\u2010fetal medicine. Obstetric care consensus No. 6: Periviable Birth. obstet Gynecol.2017;130:e187\u2010e199.","DOI":"10.1097\/AOG.0000000000002352"},{"key":"e_1_2_13_13_1","unstructured":"Women's Health Committee Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).Management of breech presentation.2024https:\/\/ranzcog.edu.au\/wp\u2010content\/uploads\/Management\u2010Breech\u2010Presentation.pdf. Last accessed November 26th 2024."},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70386-7"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-014-0497-6"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1987.tb00985.x"},{"issue":"578","key":"e_1_2_13_17_1","first-page":"1","article-title":"Mode of delivery at periviability and early childhood neurodevelopment","volume":"213","author":"Obi\u010dan SG","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410689"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2019.0180"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002046"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.10244"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1997.tb07414.x"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7210963"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.7.991"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)34975-6"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1039"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.10.017"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02840-3"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001131"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.03.002"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1159\/000358189"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318265b16c"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.5725"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1309"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2013.06.026"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.11.011"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2019.03.008"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.15028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:40:04Z","timestamp":1741718404000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.15028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/aogs.15028"],"URL":"https:\/\/doi.org\/10.1111\/aogs.15028","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2024-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}