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Vaginal vs. cesarean delivery for preterm breech presentation of singleton infants in California: a population-based study.
J Reprod Med. 2007 Jun; 52(6):473-9.JR

Abstract

OBJECTIVE

To examine the morbidity and mortality associated with vaginal breech delivery (VBD) of premature, low-birth-weight (LBW) (< 2.5 kg) newborns as compared to delivery by cesarean section.

STUDY DESIGN

A retrospective cohort study of singleton, preterm (< 37 weeks), LBW, nonanomalous newborns in California (January 1, 1991-December 31, 1999) was performed. Neonatal morbidity and mortality by route of delivery were compared.

RESULTS

Overall, 14,417 LBW, preterm, breech newborns were delivered (14% vaginally and 86% by cesarean). There were 150,570 LBW, preterm, cephalic newborns, of whom 82% were delivered vaginally. VBD of LBW newborns in nulliparous women was associated with increased neonatal mortality in newborns weighing 500-1,000 g (OR 11.7; 95% CI 7.9, 17.2), 1,001-1,500 g (OR 17.0; 95% CI 6.8, 42.7), 1,501-2,000 g (OR 7.2; 95% CI 2.4, 21.4), and 2,001-2,500 g (OR 6.6; 95% CI 2.1, 21.2) as compared with breech delivery by cesarean in nulliparous women. Birth trauma was increased in VBD of newborns weighing 1,500-2,000 g (OR 3.8; 95% CI 1.4, 10.1) and 2,001-2,500 g (OR 4.5; 95% CI 2.6, 7.9) as compared to breech delivery by cesarean in nulliparous women. Birth asphyxia was increased in breech newborns weighing 2,001-2,500 g (OR 3.5; 95% CI 2.2, 5.6) delivered vaginally in nulliparous women as compared to cephalic vaginal deliveries.

CONCLUSION

VBD of the preterm, LBW newborn is associated with significantly increased neonatal mortality as compared to cesarean section at similar birth weights. Birth trauma (> 1,500 g) was greater with VBD as compared to breech delivery by cesarean, and asphyxia (> 2,000 g) was greater with VBD as compared to cephalic vaginal delivery, suggesting that cesarean delivery may be a safer route of delivery for preterm breech fetuses.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of California, Davis, and Health Information Solutions, Rocklin, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17694963

Citation

Robilio, Peter A., et al. "Vaginal Vs. Cesarean Delivery for Preterm Breech Presentation of Singleton Infants in California: a Population-based Study." The Journal of Reproductive Medicine, vol. 52, no. 6, 2007, pp. 473-9.
Robilio PA, Boe NM, Danielsen B, et al. Vaginal vs. cesarean delivery for preterm breech presentation of singleton infants in California: a population-based study. J Reprod Med. 2007;52(6):473-9.
Robilio, P. A., Boe, N. M., Danielsen, B., & Gilbert, W. M. (2007). Vaginal vs. cesarean delivery for preterm breech presentation of singleton infants in California: a population-based study. The Journal of Reproductive Medicine, 52(6), 473-9.
Robilio PA, et al. Vaginal Vs. Cesarean Delivery for Preterm Breech Presentation of Singleton Infants in California: a Population-based Study. J Reprod Med. 2007;52(6):473-9. PubMed PMID: 17694963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaginal vs. cesarean delivery for preterm breech presentation of singleton infants in California: a population-based study. AU - Robilio,Peter A, AU - Boe,Nina M, AU - Danielsen,Beate, AU - Gilbert,William M, PY - 2007/8/19/pubmed PY - 2007/9/14/medline PY - 2007/8/19/entrez SP - 473 EP - 9 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 52 IS - 6 N2 - OBJECTIVE: To examine the morbidity and mortality associated with vaginal breech delivery (VBD) of premature, low-birth-weight (LBW) (< 2.5 kg) newborns as compared to delivery by cesarean section. STUDY DESIGN: A retrospective cohort study of singleton, preterm (< 37 weeks), LBW, nonanomalous newborns in California (January 1, 1991-December 31, 1999) was performed. Neonatal morbidity and mortality by route of delivery were compared. RESULTS: Overall, 14,417 LBW, preterm, breech newborns were delivered (14% vaginally and 86% by cesarean). There were 150,570 LBW, preterm, cephalic newborns, of whom 82% were delivered vaginally. VBD of LBW newborns in nulliparous women was associated with increased neonatal mortality in newborns weighing 500-1,000 g (OR 11.7; 95% CI 7.9, 17.2), 1,001-1,500 g (OR 17.0; 95% CI 6.8, 42.7), 1,501-2,000 g (OR 7.2; 95% CI 2.4, 21.4), and 2,001-2,500 g (OR 6.6; 95% CI 2.1, 21.2) as compared with breech delivery by cesarean in nulliparous women. Birth trauma was increased in VBD of newborns weighing 1,500-2,000 g (OR 3.8; 95% CI 1.4, 10.1) and 2,001-2,500 g (OR 4.5; 95% CI 2.6, 7.9) as compared to breech delivery by cesarean in nulliparous women. Birth asphyxia was increased in breech newborns weighing 2,001-2,500 g (OR 3.5; 95% CI 2.2, 5.6) delivered vaginally in nulliparous women as compared to cephalic vaginal deliveries. CONCLUSION: VBD of the preterm, LBW newborn is associated with significantly increased neonatal mortality as compared to cesarean section at similar birth weights. Birth trauma (> 1,500 g) was greater with VBD as compared to breech delivery by cesarean, and asphyxia (> 2,000 g) was greater with VBD as compared to cephalic vaginal delivery, suggesting that cesarean delivery may be a safer route of delivery for preterm breech fetuses. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/17694963/Vaginal_vs__cesarean_delivery_for_preterm_breech_presentation_of_singleton_infants_in_California:_a_population_based_study_ L2 - https://medlineplus.gov/cesareansection.html DB - PRIME DP - Unbound Medicine ER -