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Long-term follow-up of cognitive outcome after breech presentation at birth
H T Sørensen1, F H Steffensen, J Olsen
1Danish Epidemiology Science Centre at the Institute of Epidemiology and Social Medicine, University of Aarhus.
Insights
Births in breech presentation are linked to lower cognitive function scores in adulthood. This association between breech birth and cognitive outcomes persists even after accounting for delivery method and other factors.
Area of Science:
- Obstetrics and Gynecology
- Developmental Pediatrics
- Cognitive Neuroscience
Background:
- Long-term consequences of breech presentation birth are not well-documented.
- Previous research has not extensively explored the impact of birth presentation on later cognitive function.
Purpose of the Study:
- To investigate the association between breech presentation at birth and cognitive outcomes in adulthood.
- To determine if delivery method (Caesarean section vs. vaginal) modifies the relationship between breech presentation and cognitive function.
Main Methods:
- A cohort study design was employed, linking birth registry data with military conscription records.
- Cognitive function was assessed using the Boerge Prien IQ test in 4,298 male conscripts born between 1973 and 1976.
- Analyses included stratification by Caesarean section, adjustment for confounders, and restriction to term singleton pregnancies.
Main Results:
- Men born in breech presentation (n=164) had lower mean Boerge Prien IQ scores (39.9) compared to those born in cephalic presentation (n=4,134, mean score 43.2).
- The difference in IQ scores was statistically significant (3.3 points, 95% CI 1.8-4.7).
- This negative association between breech birth and cognitive outcome remained consistent across various analytical approaches, including adjustments for delivery mode and confounders.
Conclusions:
- Breech presentation at birth is associated with a measurable deficit in cognitive function in adulthood.
- The findings suggest that breech presentation itself, independent of delivery method, may have long-term implications for cognitive development.
- Further research is warranted to understand the underlying mechanisms linking breech birth to cognitive outcomes.
Abstract:
Studies of long-term consequences of birth in breech presentation are sparse. Therefore, we conducted a cohort study linking birth registry data with data collected during evaluation for military service in 4,298 conscripts born between 1973 and 1976. The cognitive functions were measured with the Boerge Prien IQ test. A total of 164 conscripts were born in breech presentation and 70 (42.7%) of these were delivered after Caesarean section. The mean Boerge Prien test score was 43.2 among men born in cephalic presentation and 39.9 among those born in breech presentation for a difference of 3.3 (95% confidence interval = 1.8-4.7). The negative association between breech presentation and cognitive outcome persisted after stratifying by Caesarean section and after adjustment for confounders. It also persisted when we restricted the analyses to term singleton pregnancies.
