Maternal and neonatal outcome after vaginal breech delivery at term of children weighing more or less than 3.8 kg: A FRABAT prospective cohort study

• Published in: PloS one 2018-08, Vol.13 (8), p.e0202760-e0202760
• Main Authors: Jennewein, Lukas, Kielland-Kaisen, Ulrikke, Paul, Bettina, Möllmann, Charlotte J, Klemt, Anna-Sophia, Schulze, Sally, Bock, Nina, Schaarschmidt, Wiebke, Brüggmann, Dörthe, Louwen, Frank
• Format: Article
• Language: English
• Subjects: Adult; Biology and Life Sciences; Birth injuries; Birth Weight; Body mass index; Breech Presentation; Care and treatment; Cesarean section; Chi-square test; Childbirth & labor; Children; Cohort analysis; Committees; Complications and side effects; Delivery, Obstetric - methods; Female; Fetal Weight; Fetuses; Goethe, Johann Wolfgang von (1749-1832); Gynecology; Health aspects; Health risk assessment; Health risks; Hospitals; Humans; Infant, Newborn; Infants; Logistic Models; Maternal Age; Medicine; Medicine and Health Sciences; Morbidity; Neonates; Newborn babies; Newborn infants; Obstetrics; Patient outcomes; Patients; Practice Guidelines as Topic; Pregnancy; Pregnancy Outcome; Prospective Studies; Regression analysis; Risk factors; Systematic review; Vagina; Weighing; Weight reduction; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0202760

The clinical management of breech presentations at term is still a controversially discussed issue among clinicians. Clear predictive criteria for planned vaginal breech deliveries are desperately needed to prevent adverse fetal and maternal outcomes and to reduce elective cesarean section rates. The green-top guideline considers an estimated birth weight of 3.8 kg or more an indication to plan a cesarean section despite the lack of respective evidence. To compare maternal and neonatal outcome of vaginal intended breech deliveries of births with children with a birth weight of 2.5 kg- 3.79 kg and children with a birth weight of 3.8 kg and more. Prospective cohort study. All vaginal intended deliveries out of a breech position of newborns weighing between 2.5 kg and 4.5 kg at the Obstetrics department at Goethe University Hospital Frankfurt from January 2004 until December 2016. Neonatal and maternal outcome of a light weight group (LWG) (< 3.8 kg) was compared to and a high weight group (HWG) (≥ 3.8 kg) using Pearson's Chi Square test and Fishers exact test. A logistic regression analysis was performed to detect an association between cesarean section rates, fetal outcome and the birth weight. No difference in neonatal morbidity was detected between the HWG (1.8%, n = 166) and the LWG (2.6%, n = 888). Cesarean section rate was significantly higher in the HWG with 45.2% in comparison to 28.8% in the LWG with an odds ratio of 1.57 (95% CI 1.29-1.91, p