Births of extremely preterm infants, less than 26 weeks' gestation, by cesarean section have increased significantly in the United States over the past decade. The justification for this increase is not well supported in the literature. This review examines recent analyses that suggest there may be some survival advantage for infants less than 26 weeks delivered by cesarean section. The appropriateness of intervening with cesarean sections for these very immature infants, however, remains uncertain.
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