Low Birthweight Breech Infant: Short-Term and Long-Term Outcome by Method of Delivery

Weissman, Amir; Blazer, Shraga; Zimmer, Etan Z.; Jakobi, Peter; Paldi, E

doi:10.1055/s-2007-999706

Cited by 17 publications

(3 citation statements)

References 3 publications

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“…4 Preterm fetuses in breech position may also benefit from cesarean delivery. Previous analyses have shown a lower mortality for cesarean delivery as compared to vaginal births in preterm breech infants with birth weights greater than 500 g. 5,6 Adverse outcomes, such as neurologic sequelae and intraventricular hemorrhage, have been observed to be decreased after cesarean delivery in breech preterm infants, especially in infants with birth weights of 750 to 1500 g. [7][8][9] However, the conclusions of these studies are limited by their retrospective design. Attempts at prospective trials have been unsuccessful.…”

Section: Introductionmentioning

confidence: 99%

Delivery mode by race for breech presentation in the US

2007

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Objective: To determine if there are differential cesarean delivery rates by race and other socio-demographic factors for women with breech infants.Study Design: We calculated cesarean delivery rates for 186 727 White, African American, Hispanic and Asian women delivering breech singletons with gestational age 26 to 41 weeks born in 1999 and 2000 using data from the National Center for Health Statistics. Multivariable logistic regression was used to determine differences in mode of delivery by race, adjusting for socio-demographic and medical factors.Results: Cesarean rates for breech were >80% in most gestational age groups. In 14 of 18 groups, Whites had higher cesarean delivery rates than African Americans. However, this finding did not persist after risk adjustment. Hispanics were more likely to deliver by cesarean delivery than African Americans and Whites.Conclusion: Breech singleton infants are predominantly born by cesarean delivery. Although African-American women with breech presentation have lower cesarean delivery rates than Whites, this difference is not present after adjusting for socio-demographic and medical factors. Hispanics were more likely to be delivered by cesarean delivery and this difference was amplified after risk adjustment. Asians had slightly lower cesarean rates after risk adjustment, but this varied widely according to Asian subgroup.

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Section: Introductionmentioning

confidence: 99%

Delivery mode by race for breech presentation in the US

2007

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“…It is said that it avoids the mechanical problems of the breech infant, which may cause trauma and/or asphyxia. Results from a number of observational studies [4, 24,25] and two population-based studies [14,15] suggest that vaginal delivery is associated with higher risk of death and morbidity compared to cesarean section. However, others have not found a difference in outcomes between the two modes of delivery [1, 5, 8, 9, 16, 18Ϫ20, 22, 26].…”

Section: Introductionmentioning

confidence: 99%

Comparison of vaginal and cesarean section delivery for fetuses in breech presentation

Ismail

Nagib²,

Ismail³

et al. 1999

Journal of Perinatal Medicine

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The poor perinatal outcomes of breech delivered infants are due primarily to VLBW, congenital malformations, and premature labor. Although abdominal delivery had a lower NNM rate than vaginal delivery, the difference was not significant after adjustment for confounding factors. The results confirm the findings of a previously analyzed similar series delivered at our institution between 1980 and 1987. They suggest that, with appropriate technique, abdominal delivery is not mandatory in breech presentation.

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“…The sizes of such biases are likely to be larger than any differential effects of the two methods of delivery. Nevertheless, many authors have concluded, on the basis of unadjusted analyses, that the preterm breech infant is best delivered by caesarean section 2–3 , whereas investigators who have attempted to adjust for some of these biases by statistical adjustment of their data have shown little or no clear advantage of caesarean delivery 4–6 . Reflecting this, some authors have advised that selected preterm breech infants should be allowed to be born vaginally 7–9 .…”

Section: Introductionmentioning

confidence: 99%

A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant

Penn

Steer

Grant³

1996

BJOG

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Objective To determine the optimum mode of delivery for women in preterm breech labour at a gestational age of 26 to 32 weeks. Design A multicentre randomised controlled trial. Setting Twenty‐six hospitals in England, UK. Participants Women with a singleton breech fetus in spontaneous preterm labour between 26 and 32 completed weeks of gestation, with no clear indication for a caesarean section or vaginal breech delivery. Intervention Random allocation to either ‘intention to delivery vaginally’ or ‘intention to deliver by caesarean section’. Main outcome measures Perinatal mortality, neonatal morbidity, maternal morbidity and gestation at delivery. Results The trial was closed after 17 months because of low recruitment, by which time substantial numbers of women had been in the eligible gestation period. Thirteen women from six hospitals were recruited. One infant, randomised to and delivered vaginally, was stillborn. Three fetal presentations were cephalic at delivery despite a diagnosis of breech presentation at trial entry. No formal statistical analysis was performed due to the small numbers. Conclusions No conclusions about the optimum mode of delivery for women in preterm labour with a fetus presenting by the breech can be drawn from this trial. The low accrual rate was due to clinicians' reluctance to randomise eligible women, reflecting the circumstances and nature of the trial.

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Low Birthweight Breech Infant: Short-Term and Long-Term Outcome by Method of Delivery

Cited by 17 publications

References 3 publications

Delivery mode by race for breech presentation in the US

Delivery mode by race for breech presentation in the US

Comparison of vaginal and cesarean section delivery for fetuses in breech presentation

A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant

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