title: Subsequent pregnancy outcome after preterm breech delivery, a population based cohort study.
abstract: OBJECTIVE
  The objective of this study is to investigate the effect of the mode of delivery in women with preterm breech presentation on neonatal and maternal outcome in the subsequent pregnancy.
  
  
  METHODS
  Nationwide population-based cohort study in the Netherlands of women with a preterm breech delivery and a subsequent delivery in the years 1999-2007. We compared planned caesarean section versus planned vaginal delivery for perinatal outcomes in both pregnancies.
  
  
  RESULTS
  We identified 1543 women in the study period, of whom 259 (17%) women had a planned caesarean section and 1284 (83%) women had a planned vaginal delivery in the first pregnancy. In the subsequent pregnancy, perinatal mortality was 1.1% (3/259) for women with a planned caesarean section in the first pregnancy and 0.5% (6/1284) for women with a planned vaginal delivery in the first pregnancy (aOR 1.8; 95% CI 0.31-10.1). Composite adverse neonatal outcome was 2.3% (6/259) versus 1.5% (19/1284), (aOR 1.5; 95% CI 0.55-4.2). The average risk of perinatal mortality over two pregnancies was 1.9% (10/518) for planned caesarean section and 2.0% (51/2568) for planned vaginal delivery, (OR 0.98; 95% CI 0.49-1.9).
  
  
  CONCLUSIONS
  In women with a preterm breech delivery, planned caesarean section does not reduce perinatal mortality, perinatal morbidity, or maternal morbidity rate over the course of two pregnancies.
authors.affiliation: a Department of Obstetrics and Gynaecology , ZGT , Almelo , The Netherlands .
authors.forename: Lester
authors.initials: L
authors.lastname: Bergenhenegouwen
authors.affiliation: b Department of Obstetrics and Gynaecology and.|c Department of Medical Informatics , Amsterdam Medical Centre, Amsterdam, The Netherlands , and.
authors.forename: Sabine
authors.initials: S
authors.lastname: Ensing
authors.affiliation: c Department of Medical Informatics , Amsterdam Medical Centre, Amsterdam, The Netherlands , and.
authors.forename: Anita C J
authors.initials: AC
authors.lastname: Ravelli
authors.affiliation: b Department of Obstetrics and Gynaecology and.
authors.forename: Jelle
authors.initials: J
authors.lastname: Schaaf
authors.affiliation: b Department of Obstetrics and Gynaecology and.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Kok
authors.affiliation: d The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide , Australia.
authors.forename: Ben-Willem
authors.initials: BW
authors.lastname: Mol
mesh_terms: D000328:Adult; D001946:Breech Presentation / Q000628:therapy*; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D009426:Netherlands; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D012042:Registries; D012189:Retrospective Studies
keywords: Caesarean section; maternal morbidity and mortality; neonatal morbidity and mortality; preterm breech presentation; subsequent pregnancy