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Breech presentation at term and associated obstetric risks factors-a nationwide population based cohort study
Georg Macharey1, Mika Gissler2, Leena Rahkonen3
1Department of Obstetrics and Gynecology, Helsinki University Hospital (HUS), University of Helsinki, Haartmaninkatu 2, 00290, Helsinki, Finland. georg.macharey@hus.fi.
Archives of Gynecology and Obstetrics
|February 9, 2017
Summary
Breech presentation at term is linked to higher stillbirth rates and several risk factors, including fetal growth restriction and congenital anomalies. This highlights the need for careful management of term breech pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Reproductive Health
Background:
- Breech presentation at term is a significant obstetric concern.
- Understanding associated risk factors is crucial for managing adverse fetal outcomes.
Purpose of the Study:
- To determine if term breech presentation is associated with known obstetric risk factors for adverse fetal outcomes.
- To analyze the relationship between breech presentation and specific risk factors in singleton deliveries.
Main Methods:
- Retrospective, nationwide Finnish population-based cohort study.
- Comparison of obstetric risks in term breech versus vertex singleton deliveries (2005-2014).
- Multivariable logistic regression analysis to identify significant risk factors.
Main Results:
- Term breech presentation occurred in 2.4% of singleton pregnancies.
- Stillbirth rate was significantly higher in term breech presentations (0.2% vs 0.1%).
- Associated risk factors included fetal growth restriction (OR 1.19), oligohydramnios (OR 1.42), gestational diabetes (OR 1.06), prior cesarean section (OR 2.13), and congenital fetal abnormalities (OR 2.01).
Conclusions:
- Term breech presentation is independently associated with antenatal stillbirth.
- Identified risk factors for adverse perinatal outcomes include oligohydramnios, fetal growth restriction, gestational diabetes, prior cesarean section, and congenital anomalies.
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