Preterm breech presentation: A comparison of intended vaginal and intended cesarean delivery

Lester Bergenhenegouwen, Floortje Vlemmix, Sabine Ensing, Jelle Schaaf, Joris Van Der Post, Ameen Abu-Hanna, Anita C J Ravelli, Ben W. Mol, Marjolein Kok

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE: To study the association of the intended mode of delivery and perinatal morbidity and mortality among breech fetuses who are delivered preterm. METHODS: We conducted a nationwide cohort study of women with a singleton pregnancy in breech presentation who delivered preterm (26 0/7-36 6/7 weeks of gestation) in the years 2000-2011. We compared perinatal outcomes according to the intended and actual mode of delivery using multivariate logistic regression analysis. We performed subgroup analyses of gestational age and parity. RESULTS: We studied 8,356 women with a preterm singleton breech delivery. Intended cesarean delivery (n1,935) was not associated with a significant reduction in perinatal mortality compared with intended vaginal delivery (n6,421) (1.3% compared with 1.5%; adjusted odds ratio [OR] 0.97, 95% confidence interval [CI] 0.60-1.57). However, the composite of perinatal mortality and morbidity was significantly reduced in the intended cesarean delivery group (8.7% compared with 10.4%; adjusted OR 0.77, 95% CI 0.63-0.93). In the subgroup of women delivering at 28-32 weeks of gestation, intended cesarean delivery was associated with a 1.7% risk of perinatal mortality compared with 4.1% with intended vaginal delivery (adjusted OR 0.27, 95% CI 0.10-0.77) and significantly reduced composite mortality and severe morbidity, 5.9% compared with 10.1% (adjusted OR 0.37, 95% CI 0.20-0.68). CONCLUSION: In women delivering a preterm breech fetus, cesarean delivery is associated with reduced perinatal mortality and morbidity.

LanguageEnglish
Pages1223-1230
Number of pages8
JournalObstetrics and gynecology
Volume126
Issue number6
DOIs
Publication statusPublished - 1 Dec 2015

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Bergenhenegouwen, L., Vlemmix, F., Ensing, S., Schaaf, J., Van Der Post, J., Abu-Hanna, A., ... Kok, M. (2015). Preterm breech presentation: A comparison of intended vaginal and intended cesarean delivery. Obstetrics and gynecology, 126(6), 1223-1230. https://doi.org/10.1097/AOG.0000000000001131
Bergenhenegouwen, Lester ; Vlemmix, Floortje ; Ensing, Sabine ; Schaaf, Jelle ; Van Der Post, Joris ; Abu-Hanna, Ameen ; Ravelli, Anita C J ; Mol, Ben W. ; Kok, Marjolein. / Preterm breech presentation : A comparison of intended vaginal and intended cesarean delivery. In: Obstetrics and gynecology. 2015 ; Vol. 126, No. 6. pp. 1223-1230.
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Bergenhenegouwen, L, Vlemmix, F, Ensing, S, Schaaf, J, Van Der Post, J, Abu-Hanna, A, Ravelli, ACJ, Mol, BW & Kok, M 2015, 'Preterm breech presentation: A comparison of intended vaginal and intended cesarean delivery', Obstetrics and gynecology, vol. 126, no. 6, pp. 1223-1230. https://doi.org/10.1097/AOG.0000000000001131

Preterm breech presentation : A comparison of intended vaginal and intended cesarean delivery. / Bergenhenegouwen, Lester; Vlemmix, Floortje; Ensing, Sabine; Schaaf, Jelle; Van Der Post, Joris; Abu-Hanna, Ameen; Ravelli, Anita C J; Mol, Ben W.; Kok, Marjolein.

In: Obstetrics and gynecology, Vol. 126, No. 6, 01.12.2015, p. 1223-1230.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preterm breech presentation

T2 - Obstetrics and gynecology

AU - Bergenhenegouwen, Lester

AU - Vlemmix, Floortje

AU - Ensing, Sabine

AU - Schaaf, Jelle

AU - Van Der Post, Joris

AU - Abu-Hanna, Ameen

AU - Ravelli, Anita C J

AU - Mol, Ben W.

AU - Kok, Marjolein

PY - 2015/12/1

Y1 - 2015/12/1

N2 - OBJECTIVE: To study the association of the intended mode of delivery and perinatal morbidity and mortality among breech fetuses who are delivered preterm. METHODS: We conducted a nationwide cohort study of women with a singleton pregnancy in breech presentation who delivered preterm (26 0/7-36 6/7 weeks of gestation) in the years 2000-2011. We compared perinatal outcomes according to the intended and actual mode of delivery using multivariate logistic regression analysis. We performed subgroup analyses of gestational age and parity. RESULTS: We studied 8,356 women with a preterm singleton breech delivery. Intended cesarean delivery (n1,935) was not associated with a significant reduction in perinatal mortality compared with intended vaginal delivery (n6,421) (1.3% compared with 1.5%; adjusted odds ratio [OR] 0.97, 95% confidence interval [CI] 0.60-1.57). However, the composite of perinatal mortality and morbidity was significantly reduced in the intended cesarean delivery group (8.7% compared with 10.4%; adjusted OR 0.77, 95% CI 0.63-0.93). In the subgroup of women delivering at 28-32 weeks of gestation, intended cesarean delivery was associated with a 1.7% risk of perinatal mortality compared with 4.1% with intended vaginal delivery (adjusted OR 0.27, 95% CI 0.10-0.77) and significantly reduced composite mortality and severe morbidity, 5.9% compared with 10.1% (adjusted OR 0.37, 95% CI 0.20-0.68). CONCLUSION: In women delivering a preterm breech fetus, cesarean delivery is associated with reduced perinatal mortality and morbidity.

AB - OBJECTIVE: To study the association of the intended mode of delivery and perinatal morbidity and mortality among breech fetuses who are delivered preterm. METHODS: We conducted a nationwide cohort study of women with a singleton pregnancy in breech presentation who delivered preterm (26 0/7-36 6/7 weeks of gestation) in the years 2000-2011. We compared perinatal outcomes according to the intended and actual mode of delivery using multivariate logistic regression analysis. We performed subgroup analyses of gestational age and parity. RESULTS: We studied 8,356 women with a preterm singleton breech delivery. Intended cesarean delivery (n1,935) was not associated with a significant reduction in perinatal mortality compared with intended vaginal delivery (n6,421) (1.3% compared with 1.5%; adjusted odds ratio [OR] 0.97, 95% confidence interval [CI] 0.60-1.57). However, the composite of perinatal mortality and morbidity was significantly reduced in the intended cesarean delivery group (8.7% compared with 10.4%; adjusted OR 0.77, 95% CI 0.63-0.93). In the subgroup of women delivering at 28-32 weeks of gestation, intended cesarean delivery was associated with a 1.7% risk of perinatal mortality compared with 4.1% with intended vaginal delivery (adjusted OR 0.27, 95% CI 0.10-0.77) and significantly reduced composite mortality and severe morbidity, 5.9% compared with 10.1% (adjusted OR 0.37, 95% CI 0.20-0.68). CONCLUSION: In women delivering a preterm breech fetus, cesarean delivery is associated with reduced perinatal mortality and morbidity.

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U2 - 10.1097/AOG.0000000000001131

DO - 10.1097/AOG.0000000000001131

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JO - Obstetrics and gynecology

JF - Obstetrics and gynecology

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Bergenhenegouwen L, Vlemmix F, Ensing S, Schaaf J, Van Der Post J, Abu-Hanna A et al. Preterm breech presentation: A comparison of intended vaginal and intended cesarean delivery. Obstetrics and gynecology. 2015 Dec 1;126(6):1223-1230. https://doi.org/10.1097/AOG.0000000000001131