Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation : a nationwide, population-based record linkage study

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Macharey , G , Väisänen-Tommiska , M , Gissler , M , Ulander , V-M , Rahkonen , L , Nuutila , M & Heinonen , S 2018 , ' Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation : a nationwide, population-based record linkage study ' , Journal of Perinatal Medicine , vol. 46 , no. 3 , pp. 333-339 . https://doi.org/10.1515/jpm-2017-0127

Title: Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation : a nationwide, population-based record linkage study
Author: Macharey, Georg; Väisänen-Tommiska, Mervi; Gissler, Mika; Ulander, Veli-Matti; Rahkonen, Leena; Nuutila, Mika; Heinonen, Seppo
Other contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Clinicum
University of Helsinki, HUS Gynecology and Obstetrics
University of Helsinki, Clinicum



Date: 2018-04
Language: eng
Number of pages: 7
Belongs to series: Journal of Perinatal Medicine
ISSN: 0300-5577
DOI: https://doi.org/10.1515/jpm-2017-0127
URI: http://hdl.handle.net/10138/243953
Abstract: Purpose: To evaluate whether a trial of planned vaginal breech labor affects neurologic development in children. Methods: This is a nationwide, Finnish, population-based record linkage study. An odds ratio with 95% confidence intervals was used to estimate the relative risk that a child delivered by planned vaginal breech labor would be diagnosed with adverse neurodevelopmental outcome (cerebral palsy, epilepsy, intellectual disability, sensor neural developmental outcome, hyperactivity, speech and language problems) at the age of 4 years. The reference group were children born by planned cesarean section. Results: During a study period of 7 years, 8374 infants were delivered in breech position. Among them, 3907 (46.7%) had an attempted labor and 4467 (53.3%) infants were delivered by planned cesarean section. There were no differences in the neurodevelopmental outcome. In the planned vaginal labor group, 133 (3.4%) children had an abnormal neurodevelopmental outcome at the age of 4 years compared to 142 (3.2%) in the planned cesarean section group. Conclusion: The absolute risk of abnormal neurological outcome in breech deliveries at term was low, regardless of planned mode of birth. Planned vaginal breech labor did not increase the risk for abnormal neurological outcome compared to planned cesarean section.
Subject: Adverse perinatal outcome
CEREBRAL-PALSY
CHILDHOOD
CHILDREN
COHORT
EPILEPSY
RISK-FACTORS
TRIAL
VAGINAL BIRTH
breech delivery
cerebral palsy
epilepsy
neonatal morbidity
neurodevelopmental outcome.
3123 Gynaecology and paediatrics
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