Breech delivery at term in Denmark, 1982-92: a population-based case-control study.

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Perinatal Research

Background:

• Term breech presentation poses delivery challenges.
• Mode of delivery influences neonatal outcomes.
• Identifying risk factors for adverse neonatal outcomes in term breech deliveries is crucial.

Purpose of the Study:

• To assess the impact of intended delivery mode on neonatal outcomes in term breech births.
• To identify predictive risk factors for adverse neonatal outcomes in planned vaginal breech deliveries.

Main Methods:

• Retrospective analysis of register data (19,476 term breech deliveries, Denmark, 1982-92).
• In-depth review of medical records for cases with Apgar score < 7 at 5 minutes (n=218) and controls (n=412).
• Statistical correlation analysis to identify risk factors.

Main Results:

• Planned vaginal delivery showed a 15-fold higher risk of low Apgar score compared to elective Cesarean section.
• Low Apgar score correlated with the duration of the second stage of labor.
• No significant correlation found with maternal age, parity, birthweight, induction, augmentation, or first stage duration.

Conclusions:

• Pre-labor decisions for vaginal delivery in term breech presentation are associated with a significantly increased risk of low Apgar scores.
• Predicting low Apgar scores in women selected for vaginal breech delivery appears challenging prior to the second stage of labor.