Breech presentation at term and associated obstetric risks factors—a nationwide population based cohort study
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The aim of this study was to estimate whether breech presentation at term was associated with known individual obstetric risk factors for adverse fetal outcome.
This was a retrospective, nationwide Finnish population-based cohort study. Obstetric risks in all breech and vertex singleton deliveries at term were compared between the years 2005 and 2014. A multivariable logistic regression model was used to determine significant risk factors.
The breech presentation rate at term for singleton pregnancies was 2.4%. The stillbirth rate in term breech presentation was significantly higher compared to cephalic presentation (0.2 vs 0.1%). The odds ratios (95% CIs) for fetal growth restriction, oligohydramnios, gestational diabetes, a history of cesarean section and congenital fetal abnormalities were 1.19 CI (1.07–1.32), 1.42 CI (1.27–1.57), 1.06 CI (1.00–1.13), 2.13 (1.98–2.29) and 2.01 CI (1.92–2.11).
The study showed that breech presentation at term on its own was significantly associated with antenatal stillbirth and a number of individual obstetric risk factors for adverse perinatal outcomes. The risk factors included oligohydramnios, fetal growth restriction, gestational diabetes, history of caesarean section and congenital anomalies.
KeywordsBreech presentation Predicting factors Risk factors Fetal growth restriction Stillbirth Oligohydramnios
- 2.Martius G (1988) Lehrbuch der Geburtshilfe. 11th ed. Georg Thieme, StuttgartGoogle Scholar
- 9.Macharey G, Ulander VM, Heinonen S, Kostev K, Nuutila M, Vaisanen-Tommiska M (2016) Risk factors and outcomes in “well-selected” vaginal breech deliveries: a retrospective observational study. J Perinat Med. doi:10.1515/jpm-2015-0342
- 15.Whyte H, Hannah ME, Saigal S, Hannah WJ, Hewson S, Amankwah K et al (2004) Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. Am J Obstet Gynecol 191(3):864–871CrossRefPubMedGoogle Scholar
- 22.Wendland EM, Torloni MR, Falavigna M, Trujillo J, Dode MA, Campos MA, et al (2012) Gestational diabetes and pregnancy outcomes—a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria. BMC Pregnancy Childbirth 12:23-2393-12-23.CrossRefGoogle Scholar
- 36.Preboth M (2000) ACOG guidelines on antepartum fetal surveillance. American College of Obstetricians and Gynecologists. Am Fam Physician 62(5):1184, 1187–1188Google Scholar
- 41.Macharey G, Ulander VM, Kostev K, Vaisanen-Tommiska M, Ziller V (2014) Emergency peripartum hysterectomy and risk factors by mode of delivery and obstetric history: a 10-year review from Helsinki University Central Hospital. J Perinat Med 43:721–728Google Scholar