Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic Study

<i>Background and Objectives:</i> Forceps delivery is a crucial obstetrical technique that has become increasingly underutilized in favor of cesarean delivery, despite the numerous complications related to cesarean sections. The major concerns with regard to assisted vaginal birth (AVB)...

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Main Authors: Sanja Kostic, Katarina Ivanovic, Ivana Jovanovic, Milos Petronijevic, Natasa Cerovac, Jelena Milin-Lazovic, Danijela Bratic, Stefan Dugalic, Miroslava Gojnic, Milica Petronijevic, Milan Stojanovic, Ivan Rankovic, Svetlana Vrzic Petronijevic
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Language:English
Published: MDPI AG 2024-10-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/11/1743
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author Sanja Kostic
Katarina Ivanovic
Ivana Jovanovic
Milos Petronijevic
Natasa Cerovac
Jelena Milin-Lazovic
Danijela Bratic
Stefan Dugalic
Miroslava Gojnic
Milica Petronijevic
Milan Stojanovic
Ivan Rankovic
Svetlana Vrzic Petronijevic
author_facet Sanja Kostic
Katarina Ivanovic
Ivana Jovanovic
Milos Petronijevic
Natasa Cerovac
Jelena Milin-Lazovic
Danijela Bratic
Stefan Dugalic
Miroslava Gojnic
Milica Petronijevic
Milan Stojanovic
Ivan Rankovic
Svetlana Vrzic Petronijevic
author_sort Sanja Kostic
collection DOAJ
description <i>Background and Objectives:</i> Forceps delivery is a crucial obstetrical technique that has become increasingly underutilized in favor of cesarean delivery, despite the numerous complications related to cesarean sections. The major concerns with regard to assisted vaginal birth (AVB) are safety and long-term consequences. We aimed to investigate a neurological outcome of neonates and children at the age of 7 who were born via forceps delivery. This would greatly improve informed decision making for both mothers and obstetricians. <i>Materials and Methods:</i> A single-arm cohort study was conducted from January 2012 to December 2016 among 49 women and their children born via forceps delivery at the Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia. The Sarnat and Sarnat classification was used to evaluate the neurological status of neonates, and logistic regression analysis was employed to explore the association with perinatal factors. Long-term neurological outcomes were assessed using the Griffiths Mental Development Scale and a questionnaire for parents based on the Motor and Social Development (MSD) scale, which was derived from the Bayley-III Scale. <i>Results:</i> The main indication for forceps delivery was maternal exhaustion (79.6%), followed by fetal distress (20.4%). A pathological neurological status was observed in 16.3% of newborns, with pathological ultrasound of the CNS in 3%. A statistically significant association was observed with the Apgar score, with an odds ratio of 0.575 (95% CI: 0.407–0.813, <i>p</i> = 0.002) and perinatal asphyxia, with an odds ratio of 9.882 (95% CI: 1.111–87.902, <i>p</i> = 0.04). However, these associations were unlikely to be related to the mode of delivery. Long-term adverse neurological outcomes were seen in three cases, which accounts for 6.4%. These included mild disorders such as delayed milestone, speech delay, and motor clumsiness. <i>Conclusions:</i> The present study highlights the safety of forceps delivery regarding children’s neurological outcomes at 7 years of age. This is an important contribution to the modern management of labor, especially in light of increasing rates of cesarean deliveries worldwide.
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spelling doaj-art-cf0f6b280fa84d69a078a0e9376524922024-11-26T18:12:12ZengMDPI AGMedicina1010-660X1648-91442024-10-016011174310.3390/medicina60111743Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic StudySanja Kostic0Katarina Ivanovic1Ivana Jovanovic2Milos Petronijevic3Natasa Cerovac4Jelena Milin-Lazovic5Danijela Bratic6Stefan Dugalic7Miroslava Gojnic8Milica Petronijevic9Milan Stojanovic10Ivan Rankovic11Svetlana Vrzic Petronijevic12Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaFaculty of Medicine, Institute for Medical Statistics and Informatics, University of Belgrade, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaClinical Center Dr Dragisa Misovic, Hospital for Gynecology and Obstetrics, 11000 Belgrade, SerbiaDepartment of Gastroenterology and Liver Unit, Royal Cornwall Hospitals NHS Trust, Truro TR1 3LJ, UKClinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia<i>Background and Objectives:</i> Forceps delivery is a crucial obstetrical technique that has become increasingly underutilized in favor of cesarean delivery, despite the numerous complications related to cesarean sections. The major concerns with regard to assisted vaginal birth (AVB) are safety and long-term consequences. We aimed to investigate a neurological outcome of neonates and children at the age of 7 who were born via forceps delivery. This would greatly improve informed decision making for both mothers and obstetricians. <i>Materials and Methods:</i> A single-arm cohort study was conducted from January 2012 to December 2016 among 49 women and their children born via forceps delivery at the Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia. The Sarnat and Sarnat classification was used to evaluate the neurological status of neonates, and logistic regression analysis was employed to explore the association with perinatal factors. Long-term neurological outcomes were assessed using the Griffiths Mental Development Scale and a questionnaire for parents based on the Motor and Social Development (MSD) scale, which was derived from the Bayley-III Scale. <i>Results:</i> The main indication for forceps delivery was maternal exhaustion (79.6%), followed by fetal distress (20.4%). A pathological neurological status was observed in 16.3% of newborns, with pathological ultrasound of the CNS in 3%. A statistically significant association was observed with the Apgar score, with an odds ratio of 0.575 (95% CI: 0.407–0.813, <i>p</i> = 0.002) and perinatal asphyxia, with an odds ratio of 9.882 (95% CI: 1.111–87.902, <i>p</i> = 0.04). However, these associations were unlikely to be related to the mode of delivery. Long-term adverse neurological outcomes were seen in three cases, which accounts for 6.4%. These included mild disorders such as delayed milestone, speech delay, and motor clumsiness. <i>Conclusions:</i> The present study highlights the safety of forceps delivery regarding children’s neurological outcomes at 7 years of age. This is an important contribution to the modern management of labor, especially in light of increasing rates of cesarean deliveries worldwide.https://www.mdpi.com/1648-9144/60/11/1743forcepsassisted vaginal birthcesarean deliveryneurodevelopment
spellingShingle Sanja Kostic
Katarina Ivanovic
Ivana Jovanovic
Milos Petronijevic
Natasa Cerovac
Jelena Milin-Lazovic
Danijela Bratic
Stefan Dugalic
Miroslava Gojnic
Milica Petronijevic
Milan Stojanovic
Ivan Rankovic
Svetlana Vrzic Petronijevic
Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic Study
Medicina
forceps
assisted vaginal birth
cesarean delivery
neurodevelopment
title Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic Study
title_full Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic Study
title_fullStr Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic Study
title_full_unstemmed Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic Study
title_short Neurodevelopment of Children Born with Forceps Delivery—A Single Tertiary Clinic Study
title_sort neurodevelopment of children born with forceps delivery a single tertiary clinic study
topic forceps
assisted vaginal birth
cesarean delivery
neurodevelopment
url https://www.mdpi.com/1648-9144/60/11/1743
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