Term breech presentation in The Netherlands from 1995 to 1999: mortality and morbidity in relation to the mode of delivery of 33824 infants.
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].


METHODS
Retrospective observational study.


METHODS
The Netherlands.


METHODS
Infants (n = 33824) 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.


METHODS
Intrapartum and first-week neonatal death, 5 minute Apgar score and birth trauma. 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.
Rietberg
Christine C Th
CC
Department of Obstetrics and Gynaecology, Vlietland Hospital, Vlaardingen, The Netherlands.
Elferink-Stinkens
Patty M
PM
Brand
Ronald
R
van Loon
Aren J
AJ
Van Hemel
Oscar J S
OJ
Visser
Gerard H A
GH
D001946:Breech Presentation; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods / Q000401:mortality*; D004630:Emergencies; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D009017:Morbidity; D009426:Netherlands / Q000453:epidemiology; D007744:Obstetric Labor Complications; D016017:Odds Ratio; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors