To determine whether CS delivery and receipt of antenatal steroids (ANS) in vertex-presenting singletons with a gestational age (GA) between 24 and 30 weeks is associated with improved survival and improved severe intraventricular hemorrhage (sIVH)-free survival.STUDY DESIGN:
Multicenter cohort, retrospective analysis of prospectively collected data. Vertex-presenting singletons newborns with GA 24 to 30 weeks, birth weight between 500 and 1500 g, without major congenital malformations, born between 2001 and 2011 at Neocosur centers were included.RESULTS:
Four thousand three hundred and eighty-six infants fulfilled inclusion criteria: 45.8% were delivered vaginally and 54.2% by cesarean section (CS). Newborns delivered vaginally received less ANS, had lower GA, Apgar scores and a lower incidence of survival and sIVH-free survival (P < 0.001). Newborns with better survival were those with ANS, independent of mode of delivery. At 24 to 25 weeks GA, increased survival and sIVH-free survival were associated with ANS and CS delivery, compared with those who received ANS and delivered vaginally.CONCLUSIONS:
Among vertex-presenting singletons with GA 24 to 30 weeks, better survival and IVH-free survival were associated with ANS, independent of mode of delivery. In infants at 24 to 25 weeks gestation the combination of ANS/CS was associated with improvement in both outcomes.