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Influence of mode of delivery on neonatal mortality and morbidity in spontaneous preterm breech delivery.

Herbst, Andreas LU and Källén, Karin LU (2007) In European Journal of Obstetrics, Gynecology, and Reproductive Biology 133(1). p.25-29
Abstract
Objective: To study the association between mode of delivery and neonatal outcome in singleton pregnancy with breech presentation and preterm birth, due to premature tabour (PTL) and/or preterm premature rupture of the membranes (pPROM). Design and methods: Information on preterm (gestational week 25-36) singleton births in breech presentation in Sweden during 1990-2002 was obtained from the Swedish Medical Birth Registry and the Swedish Hospital Discharge Registry. The study groups included 1975 caesarean and 699 vaginal deliveries with a diagnosis of PTL or pPROM, without pregnancy complications implying a high risk of fetal compromise. The rates of infant respiratory distress syndrome (IRDS), intraventricular haemorrhage (IVH), low... (More)
Objective: To study the association between mode of delivery and neonatal outcome in singleton pregnancy with breech presentation and preterm birth, due to premature tabour (PTL) and/or preterm premature rupture of the membranes (pPROM). Design and methods: Information on preterm (gestational week 25-36) singleton births in breech presentation in Sweden during 1990-2002 was obtained from the Swedish Medical Birth Registry and the Swedish Hospital Discharge Registry. The study groups included 1975 caesarean and 699 vaginal deliveries with a diagnosis of PTL or pPROM, without pregnancy complications implying a high risk of fetal compromise. The rates of infant respiratory distress syndrome (IRDS), intraventricular haemorrhage (IVH), low Apgar scores, and neonatal deaths were compared between infants delivered vaginally and by caesarean section. Odds ratios were calculated with adjustment for gestational age, year of birth, maternal age and parity. Results: The risk of neonatal death and the risk of an Apgar score below 5 min postnatally were both lower after caesarean delivery (OR 0.4; 95% CI 0.2-0.7, and OR 0.4; 95% CI 0.3-0.7, respectively), whereas the risk of IRDS was increased (OR 2.1; 95% CI 1.4-3.2). A diagnosis of IRDS was not associated with mortality (OR 0.8; 95% CI 0.5-1.5). IVH was not associated with mode of delivery (OR 1.2; 95% CI 0.5-2.8). Conclusion: The lower neonatal mortality after CS supports a policy of caesarean delivery of the preterm breech. (C) 2006 Elsevier Ireland Ltd. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
preterm birth, morbidity, breech, mode of delivery, mortality, neonatal
in
European Journal of Obstetrics, Gynecology, and Reproductive Biology
volume
133
issue
1
pages
25 - 29
publisher
Elsevier
external identifiers
  • wos:000248313300005
  • scopus:34250779270
ISSN
0301-2115
DOI
10.1016/j.ejogrb.2006.07.049
language
English
LU publication?
yes
id
e25bc9fc-f75f-4611-b0f7-bd1dc4c4f3f9 (old id 160845)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16996196&dopt=Abstract
date added to LUP
2007-07-23 11:12:52
date last changed
2017-06-11 03:30:01
@article{e25bc9fc-f75f-4611-b0f7-bd1dc4c4f3f9,
  abstract     = {Objective: To study the association between mode of delivery and neonatal outcome in singleton pregnancy with breech presentation and preterm birth, due to premature tabour (PTL) and/or preterm premature rupture of the membranes (pPROM). Design and methods: Information on preterm (gestational week 25-36) singleton births in breech presentation in Sweden during 1990-2002 was obtained from the Swedish Medical Birth Registry and the Swedish Hospital Discharge Registry. The study groups included 1975 caesarean and 699 vaginal deliveries with a diagnosis of PTL or pPROM, without pregnancy complications implying a high risk of fetal compromise. The rates of infant respiratory distress syndrome (IRDS), intraventricular haemorrhage (IVH), low Apgar scores, and neonatal deaths were compared between infants delivered vaginally and by caesarean section. Odds ratios were calculated with adjustment for gestational age, year of birth, maternal age and parity. Results: The risk of neonatal death and the risk of an Apgar score below 5 min postnatally were both lower after caesarean delivery (OR 0.4; 95% CI 0.2-0.7, and OR 0.4; 95% CI 0.3-0.7, respectively), whereas the risk of IRDS was increased (OR 2.1; 95% CI 1.4-3.2). A diagnosis of IRDS was not associated with mortality (OR 0.8; 95% CI 0.5-1.5). IVH was not associated with mode of delivery (OR 1.2; 95% CI 0.5-2.8). Conclusion: The lower neonatal mortality after CS supports a policy of caesarean delivery of the preterm breech. (C) 2006 Elsevier Ireland Ltd. All rights reserved.},
  author       = {Herbst, Andreas and Källén, Karin},
  issn         = {0301-2115},
  keyword      = {preterm birth,morbidity,breech,mode of delivery,mortality,neonatal},
  language     = {eng},
  number       = {1},
  pages        = {25--29},
  publisher    = {Elsevier},
  series       = {European Journal of Obstetrics, Gynecology, and Reproductive Biology},
  title        = {Influence of mode of delivery on neonatal mortality and morbidity in spontaneous preterm breech delivery.},
  url          = {http://dx.doi.org/10.1016/j.ejogrb.2006.07.049},
  volume       = {133},
  year         = {2007},
}