Subsequent pregnancy outcome after preterm breech delivery, a population based cohort study

Lester Bergenhenegouwen, Sabine Ensing, Anita C.J. Ravelli, Jelle Schaaf, Marjolein Kok, Ben Willem Mol

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Abstract

Objective: The objective of this study is to investigate the effect of the mode of delivery in women with preterm breech presentation on neonatal and maternal outcome in the subsequent pregnancy.Methods: Nationwide population-based cohort study in the Netherlands of women with a preterm breech delivery and a subsequent delivery in the years 1999-2007. We compared planned caesarean section versus planned vaginal delivery for perinatal outcomes in both pregnancies.Results: We identified 1543 women in the study period, of whom 259 (17%) women had a planned caesarean section and 1284 (83%) women had a planned vaginal delivery in the first pregnancy. In the subsequent pregnancy, perinatal mortality was 1.1% (3/259) for women with a planned caesarean section in the first pregnancy and 0.5% (6/1284) for women with a planned vaginal delivery in the first pregnancy (aOR 1.8; 95% CI 0.31-10.1). Composite adverse neonatal outcome was 2.3% (6/259) versus 1.5% (19/1284), (aOR 1.5; 95% CI 0.55-4.2). The average risk of perinatal mortality over two pregnancies was 1.9% (10/518) for planned caesarean section and 2.0% (51/2568) for planned vaginal delivery, (OR 0.98; 95% CI 0.49-1.9).Conclusion: In women with a preterm breech delivery, planned caesarean section does not reduce perinatal mortality, perinatal morbidity, or maternal morbidity rate over the course of two pregnancies.

Original languageEnglish
Pages (from-to)2540-2544
Number of pages5
JournalThe Journal of Maternal-Fetal and Neonatal Medicine
Volume29
Issue number15
DOIs
Publication statusPublished - 2 Aug 2016
Externally publishedYes

Keywords

  • Caesarean section
  • maternal morbidity and mortality
  • neonatal morbidity and mortality
  • preterm breech presentation
  • subsequent pregnancy

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