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Common determinants of breech presentation at birth in singletons: a population-based study
Hendrik Cammu1, Noëlie Dony2, Guy Martens3
1Study Centre of Perinatal Epidemiology, Brussels, Belgium; Department Obstetrics & Gynaecology, University Hospital, VU Brussels, Belgium.
Summary
Low gestational age, birth weight, and advanced maternal age increase the risk of breech presentation. Factors like a scarred uterus, female infant, and congenital malformations also raise the odds for breech birth.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Epidemiology
Background:
- Breech presentation at birth affects approximately 4.59% of singleton deliveries.
- Identifying determinants of breech presentation is crucial for optimizing perinatal outcomes.
Purpose of the Study:
- To identify and estimate the common feto-maternal characteristics associated with singleton breech presentation at parturition.
- To provide evidence for risk stratification and potential interventions.
Main Methods:
- Population-based cohort study of 611,021 women delivering singleton babies between 2001 and 2010.
- Binary logistic regression analysis to determine independent predictors of breech presentation.
- Analysis included variables such as gestational age, birth weight, maternal age, parity, infant gender, uterine scarring, and congenital malformations.
Main Results:
- Lower gestational age and birth weight were associated with a higher incidence of breech presentation.
- Increased parity correlated with a decreased frequency of breech presentation.
- Advanced maternal age, a scarred uterus (from prior cesarean section), female infant sex, and congenital malformations were independent determinants of breech presentation.
Conclusions:
- Key risk factors for singleton breech presentation include low gestational age and birth weight, advanced maternal age, and a history of cesarean section.
- Congenital malformations and female infant sex also increase the likelihood of breech presentation.
- Parity demonstrated a protective effect, with higher parity associated with reduced odds of breech presentation.
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