How Do Pediatric Ophthalmologists Choose Between Laser and Injection Treatment for ROP?

The conversation usually happens beside an incubator. A parent who has already learned to read heart-rate monitors and oxygen saturations is now being handed a new vocabulary: zones, stages, plus disease. Then comes the question they did not expect to face this week, or ever. The eye doctor recommends treatment, and there are two ways to do it.

Families searching “rop laser vs injection” at 2 a.m. find a wall of trial acronyms and drug names, and very little that explains how a specialist actually weighs one against the other for a particular baby. That weighing is the point of this article. It is not a contest with a winner. It is a set of trade-offs that shift depending on the retina in front of the doctor.

What follows explains what each treatment does, who tends to receive which, what the evidence supports and where it is still thin, and what the days and months afterward usually involve. Every decision stays with the neonatal and ophthalmology teams caring for your child.

What retinopathy of prematurity is, and why blood vessels are the whole story

The retina is the light-sensing lining at the back of the eye, and in a full-term baby its blood supply is essentially finished at birth. Retinopathy of prematurity, or ROP, is what can happen when a baby arrives before that job is done. Vessels normally grow outward from the optic nerve toward the retina’s edge over the final weeks of pregnancy. Preterm birth interrupts the process, and the retina’s outer rim is left without a blood supply.

Starved of oxygen, that unfinished tissue sends out a chemical distress signal. The main messenger is vascular endothelial growth factor, or VEGF, a protein that tells blood vessels to grow. In small amounts it finishes the retina’s normal wiring. In excess it drives abnormal, fragile vessels that grow in the wrong direction, toward the jelly-like vitreous that fills the eye. These vessels can bleed and form scar tissue, and scar tissue can pull the retina away from the eye wall. That pulling, a retinal detachment, is how ROP damages sight.

The condition is described by two coordinates. Zone tells you where the disease is: zone I is the central circle around the optic nerve, zone II is the ring around it, zone III is the far periphery. Stage tells you how severe it is, from stage 1 (a faint line between vascular and avascular retina) to stage 5 (total detachment). “Plus disease” means the vessels near the optic nerve have become dilated and twisted, a sign the process is accelerating.

Most ROP never reaches a treatable level and simply fades as the retina matures. The National Eye Institute notes that screening focuses on babies born at 30 weeks or earlier, or weighing about 1,500 grams or less, because that is where the risk concentrates. Screening exists to catch the minority whose disease is heading somewhere dangerous, and that is the group for whom the laser-or-injection question arises.

When does ROP need treatment at all?

Before any discussion of technique, a specialist has to decide whether the retina needs intervention or simply more watching. That threshold comes largely from the Early Treatment for Retinopathy of Prematurity trial, known as ETROP, which redefined what counts as “type 1” disease, the level at which treatment is recommended rather than continued observation.

In plain terms, type 1 ROP means one of three pictures: any stage of disease in zone I with plus disease; stage 3 in zone I even without plus disease; or stage 2 or 3 in zone II with plus disease. Everything below that is watched at intervals the examining doctor sets, sometimes weekly, sometimes more often. The trial’s core finding was that treating at this earlier point, rather than waiting for the older “threshold” definition, reduced unfavorable outcomes for the retina’s structure.

Timing matters once the threshold is crossed. Aggressive disease can advance quickly, so treatment is generally arranged within a few days of the type 1 finding rather than scheduled weeks out. Parents sometimes hear this urgency as panic. It is closer to the logic of a dental filling: the sooner the damage is stopped, the less structure is lost.

Only once treatment is agreed does the second decision arrive, and it is a genuinely different question. Deciding whether to treat is a fairly standardized judgement anchored in the ETROP criteria. Deciding how to treat is more individualized, and it is where the baby’s zone, stability, and follow-up situation start to steer the choice.

A useful thing to ask at this stage is simply which zone and stage the doctor is seeing, and whether plus disease is present. Those three words explain most of what comes next.

ROP laser vs injection: how each treatment actually works

The two options attack the same problem from opposite ends. Laser removes the tissue that is sending the distress signal. Injection intercepts the signal itself.

Laser photocoagulation uses a focused beam, delivered through a headset-mounted instrument while the pupil is dilated, to place hundreds of tiny burns across the avascular peripheral retina. The treated tissue no longer produces VEGF, so the abnormal vessel growth loses its driver and regresses. The eye keeps its central retina, which is where detailed vision lives, and sacrifices the outer rim that would otherwise have carried peripheral vision. The effect is permanent because the treated tissue is permanently altered.

Anti-VEGF injection takes a different route. A medicine from the class of drugs that bind VEGF is placed directly into the vitreous through a very fine needle, a procedure called an intravitreal injection. With the growth signal blocked, the abnormal vessels shrink, and the retina’s normal vessels are given a chance to keep growing outward toward the periphery. Nothing is destroyed. The drawback is that the medicine wears off over weeks to months, and if the retina is still immature when it does, the signal can return.

Both are performed in the neonatal unit or an operating room, usually with the baby under sedation or general anesthesia for laser and often with topical anesthetic plus sedation for injection, depending on the unit’s protocol and the baby’s condition.

The generic names families may hear for anti-VEGF agents used in ROP include bevacizumab, ranibizumab, and aflibercept. Their use in infants is described in the trial literature, and the choice among them, including dosing, belongs entirely to the treating ophthalmologist and neonatologist. What matters for understanding the decision is the shared mechanism: they all remove the signal rather than the tissue.

Who usually gets laser, who usually gets an anti-VEGF injection, and who is asked to wait

Three groups emerge in most units, and the boundaries between them are softer than a checklist would suggest.

Babies who tend to receive laser are those with type 1 disease in zone II, where the avascular retina is peripheral and can be treated without sacrificing much useful field; those who are stable enough to tolerate the longer procedure and anesthesia; and those for whom the team has doubts about reliable long-term follow-up. Laser’s permanence is its virtue here. Once the peripheral retina is treated, recurrence is uncommon and the surveillance period is shorter.

Babies who tend to receive injection are those with zone I or aggressive posterior disease, where laser would have to destroy retina very close to the center of vision; those too fragile for prolonged anesthesia, since an injection takes minutes; and those whose eyes have hazy media, such as a persistent fetal vessel or vitreous hemorrhage, that would scatter a laser beam. The BEAT-ROP trial, a randomized comparison of bevacizumab and laser, reported its clearest advantage for injection in zone I disease, and that finding shapes practice widely.

Babies asked to wait are those below the type 1 threshold. Watching is not neglect. Stage 1 and 2 disease in zone II or III regresses on its own in most infants, and treating a retina that would have healed itself trades a small risk of harm for no benefit. These babies are re-examined at intervals the ophthalmologist sets, and the interval tightens if the picture changes.

Some units also use injection first to quiet aggressive disease and then apply laser later to any retina that remains unvascularized once the baby is bigger and stronger. That sequencing is a legitimate third path, not indecision.

Why the zone of disease tips the balance more than anything else

If you remember one factor from this article, make it geography. Where the disease sits in the retina does more to steer the laser-or-injection decision than any other single variable.

Picture the retina as a dartboard with the optic nerve near the bullseye and the macula, the small area responsible for sharp central vision, right beside it. Zone II and zone III disease live in the outer rings. Lasering there sacrifices peripheral field, which is a real loss but rarely a disabling one. Zone I disease lives inside the innermost circle. Treating it with laser means placing burns close to the macula, and every burn is retina that will never see again. Even with careful technique, the trade-off becomes uncomfortable.

Injection sidesteps that problem. By blocking VEGF rather than ablating tissue, it can calm zone I disease while leaving the central retina intact and allowing normal vessels to resume growth. In the BEAT-ROP trial, the recurrence rate in zone I eyes treated with laser was substantially higher than in eyes treated with injection, and it was in this posterior group that the difference reached statistical significance. For zone II eyes, the two treatments performed more similarly.

Aggressive posterior ROP, an especially fast-moving form usually located in zone I or posterior zone II, pushes the same way. Its flat, ill-defined vessels are hard to laser completely, and its speed leaves little room for a second attempt.

None of this makes injection the automatic choice for posterior disease. The team still weighs the follow-up burden and the unresolved systemic questions discussed later. But it explains why two babies with the same stage of ROP can leave the same unit with different treatments and both have received sensible care.

ROP laser vs injection at a glance: a side-by-side comparison

Tables flatten nuance, so treat this one as a map of the trade-offs rather than a scorecard. Each row is a question the specialist is answering, consciously or not, when they choose.

Question the team weighs	Laser photocoagulation	Anti-VEGF injection
What does it do to the retina?	Permanently treats the avascular periphery	Blocks the growth signal; tissue is preserved
Where does it suit best?	Zone II disease	Zone I and aggressive posterior disease
How long is the procedure?	Longer; usually under general anesthesia or deep sedation	Minutes; often topical anesthetic with sedation
Can normal vessels keep growing afterward?	No; treated retina is ablated	Yes, often incompletely
Recurrence pattern	Uncommon; tends to appear early if at all	Possible weeks to months later as the drug wears off
Follow-up duration	Shorter once regression confirmed	Longer, sometimes well past term-equivalent age
Main eye-specific downsides	Peripheral field loss; higher rates of significant myopia reported in trials	Risk of late reactivation; rare infection or lens injury
Main systemic uncertainty	Anesthesia exposure in a fragile infant	Drug enters bloodstream; long-term developmental effects still being studied

The recurrence and myopia rows draw on the BEAT-ROP randomized trial and the broader literature it prompted; the systemic-uncertainty row reflects the fact that large, long-term neurodevelopmental data remain limited. Notice that neither column is empty of drawbacks. That is the honest picture, and it is why the decision is made eye by eye rather than by policy.

Is laser treatment for ROP painful? Preparation and comfort during the procedure

Parents ask this more than anything else, and they deserve a direct answer: both procedures would be painful without anesthesia, and both are done with it. A baby is not expected to feel the laser or the needle.

Laser is the longer of the two, typically lasting a good part of an hour when both eyes are treated, and it requires the eye to be held still while several hundred spots are placed. For that reason most units perform it under general anesthesia or deep sedation with an anesthesiologist or neonatologist managing the airway. Babies who are already on ventilators are often treated in the neonatal unit itself. Those breathing on their own may be intubated for the procedure and extubated afterward.

Injection is brief. The eye is cleaned with an antiseptic, numbing drops are applied, a small speculum holds the lids open, and the needle enters through the white of the eye at a measured distance from the edge of the cornea. Many units add sedation or a sucrose pacifier for comfort. The whole thing is over in a few minutes per eye.

Preparation is mostly the neonatal team’s work. Feeds may be paused before anesthesia. The pupils are dilated with drops in the hours before either procedure so the surgeon can see the entire retina. Parents are usually able to be present before and after, though not during.

Afterward, babies can be fussier than usual, and a laser-treated eye may look red and swollen for a few days. Discomfort is managed by the unit according to its own protocols. What parents can do is what they already do best: skin-to-skin contact when permitted, a familiar voice, and patience with a baby who has had a hard day.

What the following days and weeks usually look like after each treatment

The first week after either treatment is about two things: letting the eye settle and confirming the disease is retreating. The paths then diverge.

After laser, the eyelids are often swollen and the conjunctiva red for several days. Antibiotic or anti-inflammatory drops may be prescribed by the treating team. The ophthalmologist re-examines within about a week to check that the laser spots covered the avascular retina completely and that plus disease is fading. Regression is usually visible over one to two weeks. If any untreated skip areas remain and the disease persists, a top-up laser session may follow. Once regression is confirmed and stable, examination intervals lengthen, and many babies are seen every few weeks until the specialist is satisfied the ROP is inactive.

After injection, the eye tends to look calmer sooner, sometimes within days, because the VEGF signal drops quickly. That early quiet is real but can be misleading. The retina’s own vessels now need to grow outward to finish the job the drug cannot do for them, and that takes weeks. Examinations continue at intervals the doctor sets, often weekly at first, watching both for continued regression and for the reappearance of plus disease or new abnormal vessels as the drug’s effect fades.

Discharge from the neonatal unit does not end either pathway. A baby may go home before the retina is fully mature, and outpatient eye examinations become part of the family’s calendar. Missing one is the single most avoidable way for a good result to be lost.

Beyond the acute period, all children treated for ROP need continued eye care through early childhood for refractive error, alignment problems, and amblyopia. The MedlinePlus overview of ROP describes this longer arc of follow-up as routine, not exceptional.

Can ROP come back after the injection? Why follow-up runs longer

Yes, it can, and this is the most practically important difference between the two treatments for families to understand.

Laser is permanent because it removes the source of VEGF. Injection is temporary because it removes only the VEGF present at the time, and the medicine is cleared from the eye over weeks to months. If the peripheral retina remains without a blood supply when the drug wears off, it can start signalling again. Reactivation may look like the return of plus disease, new ridge tissue, or fresh abnormal vessels, and it can be just as sight-threatening as the original episode.

The timing is what catches people out. Recurrence after laser, when it happens, tends to appear early, within the first weeks. Recurrence after anti-VEGF injection has been reported considerably later, sometimes many weeks after treatment, when the baby may already be home and looking well. In the BEAT-ROP trial, recurrence requiring retreatment was reported in 4 percent of injected eyes compared with 22 percent of lasered eyes overall, which sounds reassuring for injection; the catch is that the trial’s follow-up window was limited, and later reports describe reactivations occurring beyond it.

The practical consequence is that a baby treated with injection is examined for longer. Many specialists continue surveillance until the retina is fully vascularized or until well past the age at which reactivation is considered unlikely, and some will apply laser to any persistently avascular retina once the child is older and stronger. This is why a team may lean toward laser for a family it fears will struggle to attend repeated outpatient visits: the treatment with the shorter surveillance tail is the safer one when surveillance cannot be guaranteed.

Ask, before discharge, exactly how often examinations are needed and who to call if an appointment is missed.

What are the drawbacks of laser therapy for ROP? Side effects families should know about

People who search for “two drawbacks of laser therapy” are usually after the eye-specific costs of permanence. There are more than two, but two dominate the discussion.

The first is loss of peripheral vision. Laser deliberately destroys the outer retina that would have carried side vision. Because ROP-affected retina in that region often would not have functioned normally anyway, the practical loss is usually modest, but it is real and irreversible. Children treated with extensive laser, especially into zone I, may have a narrower visual field than peers.

The second is myopia, or short-sightedness. Eyes treated with laser have shown higher rates of significant myopia in the years after treatment than eyes treated with injection, a finding first highlighted in BEAT-ROP follow-up and echoed in subsequent studies. The mechanism is not fully understood; the laser may alter how the front of the eye grows. High myopia is manageable with glasses but adds to a child’s visual burden.

Other laser risks include cataract, a clouding of the lens, which is uncommon but recognized; bleeding within the eye; and burns to the cornea or iris if the beam is misdirected. Anesthesia itself carries risk in a fragile preterm infant, and a longer procedure means longer exposure.

Injection has its own list, which balance requires stating. Endophthalmitis, a serious infection inside the eye, is rare but possible after any intravitreal procedure. The lens can be touched by the needle. Retinal detachment has been reported when abnormal tissue contracts rapidly after treatment. And the drug does not stay in the eye; it is detectable in the bloodstream, which leads to the next section.

Neither list should frighten a family away from treatment. Untreated type 1 ROP threatens far more sight than either procedure’s complications.

What the evidence really shows about anti-VEGF injections and the developing brain

VEGF does more than grow retinal vessels. It is a signal used throughout the developing body, including in the brain, lungs, and kidneys. An injection into the eye of a very small infant reaches the bloodstream, and studies have documented measurable reductions in circulating VEGF for weeks afterward. The obvious worry follows: could suppressing that signal during a critical window affect development elsewhere?

Here the honest answer is that the evidence is reassuring but incomplete. Several observational studies comparing infants treated with anti-VEGF and laser have found either no difference in neurodevelopmental scores at toddler age or small differences that shrank once researchers accounted for the fact that injected babies were often sicker and more premature to begin with. That last point matters: the babies who receive injection are, by the logic explained earlier, disproportionately those with zone I disease and greater fragility, so a raw comparison is biased against injection from the outset.

Randomized data, which would remove that bias, are limited in size and follow-up length. The BEAT-ROP trial was designed to look at the retina, not the brain, and was not large enough to detect developmental differences. Later randomized trials of other anti-VEGF agents have reported developmental outcomes as secondary measures without clear signals of harm, but they too are modest in scale.

What a careful specialist concludes from this is neither “injection is proven safe” nor “injection is dangerous.” It is that the known, immediate risk of losing central vision to zone I disease is weighed against a theoretical, so far unconfirmed risk to development, and that in posterior disease the former usually outweighs the latter. In zone II disease, where laser works well, the calculus can tip the other way.

Ask your team how they think about this trade-off for your child. A good answer will acknowledge the uncertainty rather than dismiss it.

What people often get wrong about ROP laser and injection treatment

Some of the confusion around this topic comes from the internet mixing up different diseases, and some comes from understandable hope. A few corrections are worth making plainly.

“Laser treats ROP the way it treats diabetic retinopathy.” The tools are related, but the diseases are not. Diabetic retinopathy affects adult retinas damaged by years of high blood sugar; ROP affects a retina that has not finished forming. Success statistics quoted for laser in diabetic eyes tell you nothing about a premature baby, and applying them is a category error.

“Injection is the modern option and laser is old-fashioned.” Laser remains a standard, evidence-backed treatment and the preferred choice for much zone II disease. Newer does not mean better for every eye.

“If the eye looks calm after the injection, the problem is solved.” Early quiet is expected. Reactivation weeks later is a documented phenomenon, which is precisely why follow-up continues.

“Stage 5 ROP can be reversed.” Stage 5 is a total retinal detachment. Surgery, usually a vitrectomy to remove scar tissue and reattach the retina, can sometimes restore some light perception or navigational vision, but a fully detached, scarred infant retina does not recover normal sight. This is the strongest argument for screening and timely treatment at type 1 disease, long before stage 5.

“Treatment means the baby will need glasses forever, so it is better to wait.” Waiting past the type 1 threshold risks detachment. Glasses are a manageable outcome; detachment is not.

“One treatment is safer.” Each has a different risk profile. Safer depends on the zone, the baby, and the follow-up available, which is the whole reason a specialist decides case by case.

Questions to ask your care team before ROP treatment

Parents often feel they should not slow the team down with questions when the timeline is measured in days. In practice, a short conversation clarifies the plan for everyone, and good teams welcome it. These questions map directly onto the factors that drive the decision.

• Which zone and stage is the disease in, and is plus disease present? This tells you whether the retina is posterior enough to favor injection or peripheral enough to favor laser.
• Why are you recommending laser rather than injection for my baby, or the other way around? A clear answer will mention location, stability, and follow-up.
• Is there a reason my baby could not have the other treatment if the first one does not work?
• What kind of anesthesia or sedation will be used, and who will manage it?
• How soon after treatment will the eye be re-examined, and what are you looking for at that visit?
• If injection is chosen, how long will follow-up continue, and what would prompt a second treatment or a later laser?
• What does reactivation look like, and could I notice anything at home, or is it only detectable on examination?
• What eye problems should we expect in the toddler and preschool years, and who will follow my child for them?
• How do you think about the systemic questions around anti-VEGF for a baby this small?
• If we are discharged before the retina is mature, who coordinates the outpatient eye examinations and what happens if we miss one?

Write the answers down. Neonatal units are loud and days blur together, and the plan you hear at the bedside will be the one you need to remember in an outpatient clinic weeks later.

When to call your doctor: red-flag signs after ROP treatment

Most of what matters after ROP treatment is invisible from the outside, which is why scheduled examinations are non-negotiable. Some warning signs, however, are visible, and they warrant a same-day call to the ophthalmology or neonatal team rather than waiting for the next appointment.

• Increasing redness, swelling, or discharge from a treated eye after the first few days, or a lid that will not open, which can signal infection.
• A white or cloudy appearance in the pupil, or a pupil that looks different from the other eye.
• Persistent, unusual irritability, refusal to feed, or fever in the days after an injection, since endophthalmitis can present with a generally unwell baby.
• Any bleeding from or around the eye beyond a small spot at the injection site.
• A visible change in how the eye looks or moves: a new turn inward or outward, or an eye that seems not to track.
• Any missed follow-up appointment, particularly after injection. This is not a symptom, but it is the most common preventable route to a lost result, and the team should be told immediately so it can be rebooked.

In the longer term, through infancy and early childhood, mention to your pediatrician or eye doctor if your child seems to bump into objects on one side, holds objects very close, tilts the head to see, or has an eye that wanders. These can point to visual field loss, myopia, strabismus, or amblyopia, all of which are treatable when caught early and all of which are more common after ROP.

If you cannot reach the eye team and a baby appears acutely unwell, seek emergency care and tell the clinicians about the recent eye treatment. Every decision about further treatment rests with the specialists who know your child’s retina, and they would far rather hear from you about a false alarm than not hear about a real one.

Frequently asked questions

Is laser treatment for ROP painful for the baby?

Not during the procedure, because it is performed under general anesthesia or deep sedation managed by the neonatal or anesthesia team. Afterward, the eye can be red and swollen for a few days and babies may be fussier than usual, and the unit manages that discomfort according to its own protocols. Injection is briefer and usually done with numbing drops plus sedation or a sucrose pacifier, so it is also not expected to hurt.

What are two drawbacks of laser therapy for ROP?

The two most discussed are permanent loss of peripheral vision, because laser deliberately destroys the outer retina that would carry side vision, and a higher rate of significant myopia in later childhood compared with injection, a difference first reported in BEAT-ROP follow-up. Laser also requires longer anesthesia in a fragile infant and carries small risks of cataract or intraocular bleeding. Against these, it offers permanence and a shorter surveillance period.

Can ROP come back after the injection?

Yes. Anti-VEGF medicine wears off over weeks to months, and if the peripheral retina is still without a blood supply when it does, the growth signal can return and disease can reactivate. Reactivation has been reported well after the early period when laser recurrences typically appear. This is why babies treated with injection are examined for longer, often until the retina is fully vascularized, and why missed appointments are treated as urgent.

Which is better for ROP, anti-VEGF injection or laser treatment?

Neither is better for every eye. Randomized evidence, chiefly the BEAT-ROP trial, favors injection for zone I disease because laser there would destroy retina near the center of vision, while the two perform similarly for zone II disease. Laser offers permanence and shorter follow-up; injection preserves retina but requires longer surveillance and carries unresolved systemic questions. The treating team weighs zone, stability, and follow-up reliability for each baby.

What is the success rate of laser treatment for diabetic retinopathy, and does it apply to ROP?

It does not apply. Diabetic retinopathy is an adult disease caused by years of high blood sugar damaging a mature retina, whereas ROP affects a retina that has not finished developing. Statistics quoted for laser in diabetic eyes describe a different disease, a different population, and different outcome measures. For ROP, the relevant evidence comes from trials such as ETROP and BEAT-ROP, which your ophthalmologist can discuss.

Can ROP stage 5 be treated?

Stage 5 means the retina has fully detached, and treatment at that point is surgical, usually a vitrectomy to remove scar tissue and attempt to reattach the retina. Some children regain light perception or limited navigational vision, but a fully detached and scarred infant retina does not recover normal sight. This is the strongest argument for screening and prompt treatment at the type 1 stage, long before detachment occurs.

How long does follow-up last after ROP laser or injection?

It depends on the treatment. After laser, once the ophthalmologist confirms regression over the first couple of weeks, examination intervals lengthen and active surveillance ends when the disease is judged inactive. After injection, examinations continue until the retina is fully vascularized or the risk of reactivation has passed, which can extend for months. All children treated for ROP then need eye checks through early childhood for myopia, strabismus, and amblyopia.

What are the side effects of anti-VEGF injection for ROP?

Eye-specific risks include a rare but serious infection called endophthalmitis, injury to the lens, and retinal detachment if abnormal tissue contracts quickly after treatment. Reactivation of ROP weeks to months later is the most common concern. The medicine also reaches the bloodstream and lowers circulating VEGF for a time; studies so far have not shown clear developmental harm, but long-term randomized data remain limited, and specialists weigh this uncertainty case by case.

Why did my baby get injection when another baby on the unit got laser?

Most often because the disease was in a different location. Zone I or aggressive posterior ROP generally favors injection, since laser would need to burn retina near the macula, while zone II disease is often lasered. A baby too fragile for prolonged anesthesia, or with hazy media that would scatter a laser beam, may also receive injection. Both babies can have received appropriate care.

Will my child need glasses after ROP treatment?

Many children treated for ROP develop refractive errors, particularly myopia, and rates of significant myopia have been reported to be higher after laser than after injection. Glasses are a common and manageable outcome. Regular eye examinations through the preschool years catch refractive error, eye misalignment, and amblyopia early, when they respond best to treatment. Your ophthalmologist will set the schedule for those checks.

References

• Retinopathy of Prematurity, National Eye Institute (NIH)
• Retinopathy of prematurity, MedlinePlus Medical Encyclopedia
• Preterm birth fact sheet, World Health Organization

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.