Vaginal deliveries that used forceps or vacuum were excluded from the study, but they're not usually a factor with such small newborns, Werner explained.
The study found no difference in the incidence of brain bleeds, seizure or sepsis between the two types of delivery. While cesarean-delivered babies had lower Apgar scores -- a measure of newborn health -- the difference was not significant after taking other factors into account. But the higher risk of respiratory distress syndrome still held.
The study is slated for presentation Thursday at the annual meeting of the Society for Maternal-Fetal Medicine in Dallas.
Dr. Diane Ashton, deputy medical director of the March of Dimes, who was not involved in the new study, said the results echo other recent findings.
"This particular study shows that for infants that are premature and small-for-gestational-age, which tend to be thought of as rather fragile infants, the cesarean delivery doesn't offer any protection from the adverse outcomes," Ashton said.
In general, the March of Dimes stance "is that elective deliveries -- and that's cesarean sections and inductions -- should not occur for infants born before 39 weeks unless there's a medical indication," she noted.
"For those instances where there is a strong medical indication, either because of the mother's health or the fetus' health, I think it's important that women understand that it's a major surgery and that it can be associated with complications," Ashton added.
Werner said her team did a similar study on premature infants whose weight fell in the normal range. "We had very similar outcomes, although the respiratory distress was even more impressive and there was more of a benefit to vaginal delivery," she said.
Ashton said that vaginal birth helps babies breathe. "The process of delivering babies vaginally and going through the birth canal and getting the amniotic fluid out of the lun
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