{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:11:35Z","timestamp":1785417095751,"version":"3.56.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Compare outcomes of very preterm infants (VPIs) with a birth weight&amp;lt;1,500\u202fg based on delivery mode and propensity score matching (PSM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective study (2016\u20132021) of 1,375 VPIs (692 vaginal and 683 cesarean deliveries). PSM created 390 matched pairs. Outcomes included respiratory and neurological morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PSM revealed no significant difference between the two groups at baseline or after antenatal corticosteroids administration. The incidence rates of birth asphyxia, delivery room resuscitation, neonatal respiratory distress syndrome, use of pulmonary surfactants, pulmonary hemorrhage, and use of invasive ventilation in the vaginal delivery group after PSM were 42.3, 68.2, 65.9, 59.2, 7.2, and 36.7%, respectively. These rates were significantly lower than those in the cesarean delivery group (52.3, 83.3, 79.5, 70.8, 14.4, and 51.8%, respectively) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). The difference was more significant in infants with a gestational age of 28\u201331\n                      <jats:sup>+6<\/jats:sup>\n                      weeks (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). There were no significant differences in the incidence rates of intraventricular hemorrhage (IVH), severe IVH, periventricular leukomalacia, bronchopulmonary dysplasia, necrotizing enterocolitis (NEC), NEC surgery, premature infant retinopathy (ROP), severe ROP, late-onset neonatal sepsis, or mortality between the two groups. The mortality rate within 3\u202fdays in the vaginal delivery group was 7.7%, which was higher than that in the cesarean delivery group (3.3%), primarily in infants with a gestational age &amp;lt; 28\u202fweeks (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Cesarean section reduced early mortality in VPIs &amp;lt;28\u202fweeks but increased respiratory morbidity at 28\u201331\n                      <jats:sup>+6<\/jats:sup>\n                      weeks, with no impact on other outcomes. Since 52.1% of the cesarean sections were emergency procedures, this may have biased the results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1671581","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T05:28:29Z","timestamp":1760333309000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The delivery modes and morbidity\/mortality in very preterm infants with birth weight &lt;1,500\u202fg: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Haoran","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoming","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"ref1","year":""},{"key":"ref2","year":""},{"key":"ref3","doi-asserted-by":"publisher","first-page":"80","DOI":"10.12688\/gatesopenres.13666.1","article-title":"Study protocol for UNICEF and WHO estimates of global, regional, and national low birthweight prevalence for 2000 to 2020","volume":"6","author":"Krasevec","year":"2022","journal-title":"Gates Open Res"},{"key":"ref4","year":""},{"key":"ref5","doi-asserted-by":"publisher","first-page":"CD000078","DOI":"10.1002\/14651858.CD000078","article-title":"Caesarean section versus vaginal delivery for preterm birth in singletons","volume":"6","author":"Alfirevic","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"114.e1","DOI":"10.1016\/j.ajog.2021.07.013","article-title":"Neonatal morbidity and mortality by mode of delivery in very preterm neonates","volume":"226","author":"Zahedi-Spung","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/j.ajog.2024.06.015","article-title":"Cesarean delivery is associated with lower neonatal mortality among breech pregnancies: a systematic review and meta-analysis of preterm deliveries \u226432 weeks of gestation","volume":"231","author":"Unger","year":"2024","journal-title":"Am J Obstet Gynecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1055\/a-1815-1842","article-title":"Portuguese national registry of very low birth weight infants. 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