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Term breech birth in New South Wales, 1990-1997
C L Roberts1, B Peat, C S Algert
1NSW Centre for Perinatal Health Services Research, Department of Obstetrics and Gynaecology, University of Sydney, Australia.
Summary
Breech birth rates remained stable, but vaginal breech deliveries decreased significantly from 1990-1997. This trend led to more Cesarean sections, with no change in perinatal mortality for breech births.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Term breech presentation remains a clinical challenge.
- Mode of delivery for term breech presentation has evolved.
- Trends in breech birth management require ongoing analysis.
Purpose of the Study:
- To examine trends in term breech births and delivery modes.
- To analyze changes in Cesarean section rates for breech presentations.
- To assess perinatal mortality associated with term breech births.
Main Methods:
- Retrospective cohort study using data from 636,708 singleton births in NSW (1990-1997).
- Analysis of crude rates and adjusted odds ratios for breech birth and mode of delivery.
- Examination of perinatal mortality rates in relation to breech presentation and delivery method.
Main Results:
- Crude term breech birth rate remained stable at 3.4%, but adjusted odds decreased over time.
- Vaginal breech birth rates declined from 29.4% to 19.7%, while elective Cesarean sections increased from 49.1% to 58.4%.
- No significant change in perinatal mortality rates for breech births was observed during the study period.
Conclusions:
- Despite stable incidence, the management of term breech births shifted towards increased Cesarean delivery.
- Declining rates of vaginal breech birth may lead to a loss of procedural skills.
- External cephalic version may contribute to the observed decrease in breech presentation odds.