Secular trends in peri‐ and neonatal mortality in breech presentation; Norway 1967–1994

Albrechtsen, Susanne; Rasmussen, Svein; Irgens, Lorentz M.

doi:10.1034/j.1600-0412.2000.079006508.x

Cited by 12 publications

(10 citation statements)

References 10 publications

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“…Whyte et al (2004) were surprised to find that increased numbers of children with neurodevelopmental delay in the planned caesarean section group (14 adverse outcomes, of which 2 were deaths, sample of 457) balanced the increased numbers of deaths (13 adverse outcomes, of which 6 were deaths, sample of 463) in the planned vaginal birth group. This is likely Undiagnosed Breech: towards a woman-centred approach due to the fact that morphological and functional disorders associated with breech presentation often predate delivery (Albrechtsen et al, 2000), resulting in already compromised babies, less able to cope with the stresses of labour and birth. A policy of pre-labour caesarean section may prevent these babies from dying, but has not been shown to lessen the number of babies who at two years of age are severely delayed or have died.…”

Section: Nice Guidelinesmentioning

confidence: 99%

Undiagnosed breech: Towards a woman-centred approach

Walker

2013

British Journal of Midwifery

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The unexpected diagnosis of breech presentation upon admission in labour affects approximately 1:100 women and presents an ethical dilemma for health professionals involved, particularly when this occurs in the context of midwifery-led care. This article critically examines current guidelines recommending caesarean section on the basis of available evidence, outlines factors which must be considered in order to provide safe care, makes recommendations for women-centred counselling, and explores the role of the midwife in this situation. Conflict of Interest None knownUndiagnosed Breech: towards a woman-centred approach Background

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Section: Nice Guidelinesmentioning

confidence: 99%

Undiagnosed breech: Towards a woman-centred approach

Walker

2013

British Journal of Midwifery

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“…Breech presentation occurs in 2 to 4% of births at term [1,2] and is associated with greater perinatal mortality and morbidity than vertex presentation [3,4]. Risk factors for breech presentation include older maternal age [5][6][7], nulliparity [5][6][7], preexisting diabetes [7,8], gestational diabetes [7], smoking [5], placenta previa [7], uterine abnormalities [6,9], previous breech presentation [10], previous caesarean section [5], small fetal size [5][6][7], and congenital anomalies [6,7,10].…”

Section: Introductionmentioning

confidence: 99%

Contribution of changing risk factors to the trend in breech presentation at term

Bin

Roberts

Nicholl

et al. 2016

Aust N Z J Obstet Gynaecol

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Background: Recent population-wide changes in perinatal risk factors may affect rates of breech presentation at birth, and have implications for the provision of breech services and clinical training in breech management. Aims:To determine the trend in breech presentation at term and investigate whether changes in maternal and pregnancy characteristics explain the observed trend. Annual rates of breech presentation were determined. Logistic regression modelling was used to predict expected rates of breech presentation over time and these were compared with observed rates. A priori predictors included maternal age, country of birth, parity, smoking during pregnancy, diabetes, pregnancy hypertension, placenta praevia, previous singleton term breech, previous caesarean section, infant sex, gestational age, birthweight, and congenital anomalies. Hospital and Medicare data were used to assess trends in external cephalic version.Results: Among 914,147 singleton term births, 3.1% were breech at delivery. Rates declined from 3.6% in 2002 to 2.7% in 2012 (test for trend p<0.001). Breech presentation was predicted to increase from 3.6% in 2002 to 4.3% in 2012 because of increased maternal age, nulliparity, maternal diabetes, history of breech presentation and previous caesarean section. Use of external cephalic version appears to have increased over time.Conclusions: Breech presentation at delivery has decreased in New South Wales.Increased use of external cephalic version likely accounts for this decline, as changes in risk factors do not.

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“…Breech presentation has an increased risk of neonatal mortality compared with the overall birthing population 1. Much attention has been focussed on the optimal mode of delivery for breech-presenting babies.…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, there are very few studies investigating recurrence risk of breech presentation 1,10,11. Women (and their caregivers) are interested in the future reproductive consequences of breech presentation.…”

Section: Introductionmentioning

confidence: 99%

Recurrence of breech presentation in consecutive pregnancies

Ford

Roberts

Nassar

et al. 2010

BJOG

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ObjectiveTo investigate the recurrence risk of breech presentation at term, and to assess the risk factors that contribute to its recurrence.DesignCohort study.SettingNew South Wales, Australia.PopulationWomen with their first two (n = 113 854) and first three (n = 21 690) consecutive singleton term pregnancies, in the period 1994–2002.MethodsDescriptive statistics including rates, relative risks and adjusted relative risks, as determined from logistic regression and Poisson analyses.Main outcome measuresRates and risks of occurrence and recurrence of breech presentation at birth in each pregnancy, and maternal and infant risk factors associated with breech recurrence.ResultsFirst-time breech presentation at term occurred in 4.2% of first pregnancy deliveries, 2.2% of second pregnancies and 1.9% of third pregnancies. The rate of breech recurrence in a second consecutive pregnancy was 9.9%, and in a third consecutive pregnancy (after two prior breech deliveries) was 27.5%. The relative risk of breech recurrence in a second pregnancy was 3.2 (95% CI 2.8–3.6), and in a third consecutive breech pregnancy was 13.9 (95% CI 8.8–22.1). First pregnancy factors associated with recurrence included placenta praevia [adjusted relative risk (aRR) 2.2; 95% CI 1.3–3.7], maternal diabetes (aRR 1.4; 95% CI 1.0–2.1) and a maternal age of ≥35 years (aRR 1.2; 95% CI 0.9–1.6). Second pregnancy factors included birth defects (aRR 2.5; 95% CI 1.4–4.2), placenta praevia (aRR 2.5; 95% CI 1.5–4.1) and a female infant (aRR 1.2; 95% CI 1.0–1.5).ConclusionsThe increased recurrence risk of breech presentations suggests that women with a history of breech delivery should be closely monitored in the latter stages of pregnancy.

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Secular trends in peri‐ and neonatal mortality in breech presentation; Norway 1967–1994

Abstract: Probably due to improved obstetrical and neonatal care, mortality associated with breech presentation has substantially decreased. Increased focus especially on stillbirth, might be instrumental in further reducing the mortality associated with breech presentation.

Cited by 12 publications

References 10 publications

Undiagnosed breech: Towards a woman-centred approach

Undiagnosed breech: Towards a woman-centred approach

Contribution of changing risk factors to the trend in breech presentation at term

Recurrence of breech presentation in consecutive pregnancies

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