Neonatal and maternal outcome of small-for-gestational-age neonates delivered by vacuum-assisted delivery

Gabriel Levin, Amihai Rottenstreich, Moran Shapira, Tal Cahan, Itai Yagel, Abraham Tsur, Raanan Meyer

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the association between neonatal weight centile and neonatal and maternal morbidity following vacuum-assisted delivery (VAD) among term nulliparous women. Methods: A retrospective cohort study of all nulliparous women who delivered at term by VAD between 2011 and 2019. Deliveries were allocated into two groups and compared: (1) delivery of an small-for-gestational-age (SGA) neonate, and (2) delivery of an appropriate-for-gestational-age (AGA) neonate. Results: Overall, 3116 women were included in the study; 2878 (92.4%) were AGA and 163 (5.2%) were SGA and comprised the study groups. Neonatal and maternal adverse outcomes did not vary between groups. Rates of composite neonatal adverse outcome for SGA and AGA neonates were 26 (16.0%) versus 462 (16.1%), respectively (P = 0.972). Duration of the second stage of labor and rate of prolonged second stage were significantly lower among the SGA group compared with the AGA group (P < 0.001 for both comparisons). Maternal rates of anal sphincter injury and postpartum hemorrhage did not differ between groups. Conclusion: Neonatal outcomes among SGA neonates delivered by VAD at term did not differ from those of AGA neonates. Maternal outcome did not differ. These data provide reassurance for practitioners to perform VAD in SGA neonates at term.

Original languageEnglish
Pages (from-to)22-27
Number of pages6
JournalInternational Journal of Gynecology and Obstetrics
Issue number1
StatePublished - Jan 2022
Externally publishedYes


  • birth weight
  • neonatal morbidity
  • small for gestational age
  • term
  • vacuum-assisted delivery


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