Are race and ethnicity risk factors for breech presentation?
OBJECTIVE
To investigate race and ethnicity as risk factors for breech presentation.


METHODS
Case-control study using a population-based birth certificate registry that included linkage to Medicaid/Women, Infants, & Children (WIC) eligibility data for a socioeconomic proxy variable.


METHODS
Florida, USA.


METHODS
912,107 mothers of singletons born in Florida 1999 to 2003.


METHODS
Maternal race and ethnicity were evaluated as risk factors for breech presentation using logistic regression. The dependent variable was birth presentation. Covariates were variable measures that have been repeatedly identified as risk factors for breech presentation in the literature and are known to be highly accurate birth certificate variable measures.


RESULTS
White women were 69% more likely to have a breech baby (adjusted odds ratio [OR]=1.69, 95% confidence interval [CI] 1.63, 1.76) than Black women. Higher socioeconomic status was a risk factor in the bivariate analyses, but not in the adjusted analysis. Prematurity, nulliparity, female infant, and advancing maternal age were risk factors in the final model. The final model accounted for <5% of the total variance (Max Rescaled R(2)=4.18%), and thus was poorly fit (Hosmer and Lemeshow goodness of fit <0.0001).


CONCLUSIONS
White women were at increased risk of having a breech baby. However, important variables appear to be missing from the model.
Peterson
Caroline
C
Oregon Health & Science University, Department of Obstetrics & Gynecology, Portland, OR 97239-3098, USA. petcarol@ohsu.edu
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data; D001719:Birth Certificates; D001724:Birth Weight; D001946:Breech Presentation / Q000208:ethnology / Q000235:genetics; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005431:Florida / Q000453:epidemiology; D006630:Hispanic or Latino / Q000193:education / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008484:Medicaid / Q000706:statistics & numerical data; D008498:Medical Record Linkage; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology / Q000235:genetics; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000193:education / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data