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Is vaginal breech delivery associated with higher risk for perinatal death and cerebral palsy compared with vaginal cephalic birth? Registry-based cohort study in Norway
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  • Published on:
    Revisiting criteria for safe term breech delivery
    • Lionel Carbillon, Obstetrician Gynecologist Assistance Publique - Hopitaux de Paris
    • Other Contributors:
      • Fatma Belmaghni, Obstetrician Gynecologist
      • Ingrid Wigniolle, Obstetrician Gynecologist

    We read with great interest the population-based study of Bjellmo et al1, who evaluated from the Norwegian Medical Birth Registry from years 1999-2009 the risk for stillbirth, neonatal mortality (NNM) and cerebral palsy in children born vaginally at term in breech position, as compared with the children born vaginally in cephalic position. Indeed, thanks to this way to address the crucial question of the over risk associated with breech presentation, these authors demonstrated that children in breech had a nearly threefold increased Odds Ratio (OR) for NNM compared with children born vaginally in cephalic, regardless of whether they were born vaginally or by caesarean delivery.
    Moreover, Bjellmo et al1 also found a higher proportion of infants born small-for-gestational-age (SGA) among children born in breech than in cephalic position, and suggested that SGA foetuses (with their risk factors for adverse outcomes) are more likely to present in breech than in cephalic posi¬tion at birth.
    In line with these findings, in a recent Finnish population-based case-control study, Macharey et al2 , who revisited the risk factors associated with adverse perinatal outcome in planned vaginal breech labours at term, found that the stillbirth rate was significantly higher compared to cephalic presentation (0.2 vs 0.1%) in association with SGA, oligohydramnios, and gestational diabetes. Furthermore this same group, in another recent survey from the same cohort of mother-neonate...

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    Conflict of Interest:
    None declared.