Factors associated with adverse perinatal outcome in the Term Breech Trial - 28/08/11
for the Term Breech Trial Collaborative Group
Reprints requests to: Dr Mary E. Hannah, University of Toronto, Maternal Infant and Reproductive Health Research Unit, Centre for Research in Women's Health, Suite 751, 790 Bay St, Toronto, Ontario, M5G 1N8, Canada.Abstract |
Background |
In the Term Breech Trial, the risk of adverse perinatal outcome was lower with planned cesarean section versus planned vaginal birth. We undertook secondary analyses to determine factors associated with adverse perinatal outcome.
Study design |
By using multiple logistic regression analyses, we determined the effect of prelabor cesarean section, cesarean section during early labor, cesarean section during active labor versus vaginal birth, and other factors, on adverse perinatal outcome. For 1384 fetuses delivered after labor, we determined the effect of variables associated with labor on adverse perinatal outcome.
Results |
The risk of adverse perinatal outcome was lowest with prelabor cesarean section (odds ratio [OR]=0.13) and highest with vaginal birth. For those delivered after labor, labor augmentation (P=.007), birth weight less than 2.8 kg (P=.003), and longer time between pushing and delivery (P<.001) increased the risk, whereas the presence of an experienced clinician at delivery (P=.004) reduced the risk of adverse perinatal outcome.
Conclusion |
Breech infants at term are best delivered by prelabor cesarean section.
Le texte complet de cet article est disponible en PDF.Keywords : Cesarean section, vaginal birth, mode of delivery, labor, breech presentation
Plan
 | Supported by the Canadian Institutes of Health Research (CIHR, previously the Medical Research Council of Canada), grant No. MT 13884. M. E.H. holds a CIHR Senior Scientist Award. The Data Coordinating Centre was supported by grants from the Centre for Research in Women's Health, Sunnybrook and Women's College Health Sciences Centre, and the Department of Obstetrics and Gynecology at the University of Toronto. Presented at the Twenty-Third Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, Calif, February 3-8, 2003. The members of the Term Breech Trial Collaborative Group are listed in Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR, for the Term Breech Trial Collaborative Group. Planned cesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Lancet 2000;356:1375-83. |
Vol 189 - N° 3
P. 740-745 - septembre 2003 Retour au numéro
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