Factors associated with adverse perinatal outcome in the Term Breech Trial.
BACKGROUND
In the Term Breech Trial, the risk of adverse perinatal outcome was lower with planned cesarean section versus planned vaginal birth. We undertook secondary analyses to determine factors associated with adverse perinatal outcome.


METHODS
By using multiple logistic regression analyses, we determined the effect of prelabor cesarean section, cesarean section during early labor, cesarean section during active labor versus vaginal birth, and other factors, on adverse perinatal outcome. For 1384 fetuses delivered after labor, we determined the effect of variables associated with labor on adverse perinatal outcome.


RESULTS
The risk of adverse perinatal outcome was lowest with prelabor cesarean section (odds ratio [OR]=0.13) and highest with vaginal birth. For those delivered after labor, labor augmentation (P=.007), birth weight less than 2.8 kg (P=.003), and longer time between pushing and delivery (P<.001) increased the risk, whereas the presence of an experienced clinician at delivery (P=.004) reduced the risk of adverse perinatal outcome.


CONCLUSIONS
Breech infants at term are best delivered by prelabor cesarean section.
Su
Min
M
Department of Obstetrics and Gynecology, Sunnybrook and Women's College Health Sciences Centre.
McLeod
Lynne
L
Ross
Susan
S
Willan
Andrew
A
Hannah
Walter J
WJ
Hutton
Eileen
E
Hewson
Sheila
S
Hannah
Mary E
ME
D000328:Adult; D001724:Birth Weight; D001946:Breech Presentation; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007743:Labor, Obstetric; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors