A review of the obstetric and medical complications leading to the delivery of infants of very low birthweight

The delivery of very-low-birthweight infants is one of the major problems in human reproduction today. This study describes the principal obstetric and medical complications which led to the birth of 417 infants of 500-g to 1499-g birthweight, at the tertiary-level perinatal centre in Western Australia during the two years 1980 and 1985. An altered pattern of obstetric management of these cases was observed in 1985 compared to the management in 1980. In 1985, fewer deliveries were a result of spontaneous labour; tocolytic agents had been used in a smaller proportion of pregnancies; more infants were delivered by caesarean section without a preceding labour; and the still-birth rate was lower. Uncomplicated preterm labour was not the major cause of birth of very-low-birthweight infants. The most common factors that precipitated the delivery of very-low-birthweight infants were preterm premature rupture of the membranes (30% of cases), severe hypertension (19% of cases), antepartum haemorrhage (17% of cases) and preterm labour (17% of cases). Very low birthweight has a multifactorial aetiology, and its prevention will require a multidisciplinary approach.