Vacuum extraction in low birth weight (< 2500 g) neonates.

Purpose: To evaluate the impact of vacuum extraction on birth injuries among low birth weight neonate (2000-2499 g).
Methods: Retrospective cohort study of women with singleton pregnancies > 34 weeks, birth weight of 2000-3500 g, undergoing vacuum extraction, between 2007 and 2014. Outcomes were compared between neonates who weighed 2000-2499 g and 2500-3500 g.
Results: Out of 62,102 deliveries, 5064 (8.2%) met the inclusion criteria, of which 269 (5.3%) neonates were included in the 2000-2499 g group. In this group, gestational age at delivery was lower, the rate of preeclampsia without and with severe features was higher, the rate of induction of labor was higher as was the rate of intermediate/abnormal fetal heart rate tracings as an indication for vacuum extraction (46.2% vs. 28.0%, P < 0.001). No difference was found with regards to birth injuries (2.6% vs. 3.5%, P = 0.44). The rate of composite adverse outcomes other than birth injuries was higher in the 2000-2499 g group (13.0% vs. 9.1%, P = 0.03). Each additional 250 g in birth weight had an increased OR of 1.36 for birth injuries.
Conclusion: Vacuum extraction of neonates weighing 2000-2499 g seems to be as safe as vacuum extractions of neonates weighing 2500-3500 g in term of birth injuries.