Role of asphyxia and slow intrauterine growth in morbidity among breech delivered infants.
The outcome of breech delivery was evaluated by a neonatal neurological score and a follow-up examination at 18 months of age. The subjects were 132 children identified by ultrasound to be in breech presentation in the 33rd gestational week. 62 were born in breech presentation, while 70 turned to vertex presentation. During the early neonatal period, a neurological score was obtained based on the results of 29 items concerning posture, muscle tone, reflexes and reactions. Although there was no difference, in neurological score or in general development when the entire breech and vertex groups were compared, the SGA (small-for-gestational age) infants and the infants with low Apgar scores of the breech group had the poorest neurological scores. The contribution of certain maternal and fetal factors to postnatal condition was evaluated by a multiple linear regression analysis. Within the breech group, relationships were found between the neurological score and the variables intrauterine growth, fetal sex, and low Apgar score. A major part (66%) of the variation in neurological score was explained by the combination of these variables. These factors should therefore be taken into consideration when deciding on the mode of delivery in breech presentation.
D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000196:embryology / Q000209:etiology*; D001946:Breech Presentation; D036861:Delivery, Obstetric; D005260:Female; D005317:Fetal Growth Retardation / Q000196:embryology* / Q000503:physiopathology; D005865:Gestational Age; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D009460:Neurologic Examination; D011247:Pregnancy; D012044:Regression Analysis; D014463:Ultrasonography