Morbidity and mortality associated with mode of delivery for breech periviable deliveries

American Journal of Obstetrics and Gynecology
Brownsyne Tucker EdmondsScott A Lorch

Abstract

The purpose of this study was to estimate the odds of morbidity and death that are associated with cesarean delivery, compared with vaginal delivery, for breech fetuses who are delivered from 23-24 6/7 weeks' gestational age. We conducted a retrospective cohort study of state-level maternal and infant hospital discharge data that were linked to vital statistics for breech deliveries that occurred from 23-24 6/7 weeks' gestation in California, Missouri, and Pennsylvania from 2000-2009 (N = 1854). Analyses were stratified by gestational age (23-23 6/7 vs 24-24 6/7 weeks' gestation). Cesarean delivery was performed for 46% (335 fetuses) and 77% (856 fetuses) of 23- and 24-week breech fetuses. In multivariable analyses, overall survival was greater for cesarean-born neonates (adjusted odds ratio [AOR], 3.98; 95% confidence interval [CI], 2.24-7.06; AOR, 2.91; 95% CI, 1.76-4.81, respectively). When delivered for nonemergent indications, cesarean-born survivors were more than twice as likely to experience major morbidity (intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, asphyxia composite; AOR, 2.83; 95% CI, 1.37-5.84; AOR, 2.07; 95% CI, 1.11-3.86 at 23 and 24 weeks' gestation, respectively). Among ...Continue Reading

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Citations

Sep 13, 2015·American Journal of Obstetrics and Gynecology·Daniel W Skupski
Mar 5, 2016·Journal of Perinatology : Official Journal of the California Perinatal Association·F McKenzieB Tucker Edmonds
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Aug 29, 2021·American Journal of Obstetrics & Gynecology MFM·Amir AviramElad Mei-Dan
Dec 22, 2020·American Journal of Obstetrics & Gynecology MFM·Matthew P RomaganoLisa Gittens-Williams

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