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) 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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Journal
Medicina
Published
2024-10-24
DOI
https://doi.org/10.3390/medicina60111743
Citations
1
Primary Topic
Infant Development and Preterm Care
Type
article
Field-Weighted Citation Impact
1.11
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article

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

Nataša Cerovac, M. Petronijević, Jelena S. Milin-Lazovic, Ivan Ranković et al.
1 citations
Medicina
Infant Development and Preterm Care
1.11
article

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

Nataša Cerovac, M. Petronijević, Jelena S. Milin-Lazovic, Ivan Ranković, Svetlana Vrzić-Petronijević, D. Bratic, Ivana Jovanović, Stefan Dugalić, Katarina Ivanović, Marija Stojanović, Sanja Kostić, Milica Petronijević, Miroslava Gojnić
article en
1 citations

Abstract

<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.

MedicinaVol. 60(11)
Royal Cornwall Hospital Trust (GB), University of Belgrade (RS), University Hospital Center Dr Dragiša Mišović (RS), University Children's Hospital, Belgrade (RS)
Good health and well-being
Openalex Percentile: Top 17%
Infant Development and Preterm Care
1.11
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