‘Strong’ recommendation for those findings that were significant
Cesarean delivery associated with decreased odds of death
23w0d–27w6d: Odds Ratio (OR) 0.59; 95% CI, 0.36-0.95 (strong recommendation for cesarean)
23w0d-24w6d: OR 0.58; 95% CI, 0.44–0.75 (strong recommendation for cesarean)
25w0d-26w6d: OR 0.72; 95% CI, 0.34-1.52 (weak recommendation for cesarean)
27w0d-27w6d: OR 2.04; 95% CI, 0.20-20.62 (weak recommendation against cesarean)
Cesarean delivery associated with decreased odds of severe IVH
23w0d-27w6d: OR 0.51; 95% CI, 0.29-0.91 (strong recommendation for cesarean)
25w0d-26w6d: OR 0.29; 95% CI, 0.07–1.12 (weak recommendation for cesarean)
27w0d-27w6d: OR 0.91; 95% CI, 0.27-3.05 (weak recommendation for cesarean)
Mean proportion of head entrapment
1.1% with caesarean delivery vs 5.5% with vaginal delivery in 4 studies
Dührssen incisions were performed in one study for three cases of head entrapment
C-sections were associated with a 41% reduction in odds for death (particularly in the youngest GA bracket) and a 49% reduction in odds for intraventricular hemorrhage in actively resuscitated breech singletons <28 weeks of gestation
The authors state that “In infants born between 23+0 and 24+6 weeks, caesarean section was associated with a significant reduction in odds of death before discharge to 6 months corrected age, which according to GRADE would have a strong recommendation.”
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