Open AccessLong‐term childhood outcomes of breech presentation by intended mode of delivery: a population record linkage study
Author(s) -
Bin Yu Sun,
Ford Jane B.,
Nicholl Michael C.,
Roberts Christine L.
Publication year - 2017
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13086
Subject(s) - medicine , poisson regression , vaginal delivery , pediatrics , cerebral palsy , population , relative risk , hazard ratio , proportional hazards model , breech presentation , medical record , obstetrics , pregnancy , confidence interval , demography , surgery , physical therapy , environmental health , sociology , biology , genetics
There is a lack of information on long‐term outcomes by mode of delivery for term breech presentation. We aimed to compare childhood mortality, cerebral palsy, hospitalizations, developmental, and educational outcomes associated with intended vaginal breech birth ( VBB ) with planned cesarean section. Material and methods Population birth and hospital records from New South Wales, Australia, were used to identify women with non‐anomalous pregnancies eligible for VBB during 2001–2012. Intended mode of delivery was inferred from labor onset and management. Death, hospital, and education records were used for follow up until 2014. Cox proportional hazards regression and modified Poisson regression were used for analysis. Results Of 15 281 women considered eligible for VBB , 7.7% intended VBB , 74.2% planned cesarean section, and intention was uncertain for 18.1%. Intended VBB did not differ from planned cesarean section on infant mortality (Fisher's exact p = 0.55), childhood mortality (Fisher's exact p = 0.50), cerebral palsy (Fisher's exact p = 1.00), hospitalization in the first year of life [adjusted hazard ratio ( HR ) 1.04; 95% CI 0.90–1.20], hospitalization between the first and sixth birthdays ( HR 0.92; 95% CI 0.82–1.04), being developmentally vulnerable [adjusted relative risk ( RR ) 1.22; 95% CI 0.48–1.69] or having special needs status ( RR 0.95; 95% CI 0.48–1.88) when aged 4–6, or scoring more than 1 standard deviation below the mean on tests of reading ( RR 1.10; 95% CI 0.87–1.40) and numeracy ( RR 1.04; 95% CI 0.81–1.34) when aged 7–9. Conclusions Planned VBB confers no additional risks for child health, development or educational achievement compared with planned cesarean section.