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Term breech presentation in The Netherlands from 1995 to 1999: mortality and morbidity in relation to the mode of delivery of 33,824 infants
Author(s) -
Rietberg Christine C.Th.,
ElferinkStinkens Patty M.,
Brand Ronald,
Loon Aren J.,
Hemel Oscar J.S.,
Visser Gerard H.A.
Publication year - 2003
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1046/j.1471-0528.2003.01507.x
Subject(s) - caesarean section , medicine , breech presentation , apgar score , vaginal delivery , obstetrics , pediatrics , population , pregnancy , presentation (obstetrics) , logistic regression , gestational age , genetics , environmental health , biology
Objective To analyse neonatal mortality and morbidity in term infants born in breech presentation in relation to the mode of delivery (planned caesarean section, emergency caesarean section or vaginal delivery) and to compare these findings with those of the Term Breech Trial Collaborative Group [Hannah et al. Lancet 2000; October]. Design Retrospective observational study. Setting The Netherlands. Population Infants ( n = 33,824 ) born at term in breech presentation in the Netherlands between 1995 and 1999. Multiple pregnancies, antenatal death and major congenital malformations were excluded. Methods Data derived from the Dutch Perinatal Database were used to compare neonatal outcome of infants born in breech presentation in relation to the different modes of delivery (i.e. planned caesarean section, emergency caesarean section and vaginal delivery). Correction was made for differences in parity, duration of gestation and birthweight, using logistic regression. Main outcome measures Intrapartum and first‐week neonatal death, 5 minute Apgar score and birth trauma. Results Vaginal delivery and emergency caesarean section resulted in a sevenfold increase in low Apgar score, a threefold increase in birth trauma and a twofold increase in perinatal mortality when compared with the results of planned caesarean section. Conclusions This study confirms the data found by Hannah et al. on an increase in early neonatal morbidity and mortality, following a trial of labour in cases of term breech presentation. These data require carefully weighed consideration against increased maternal (long term) risks due to a rise in caesarean sections.