Maiju Kekki1,2, Topias Koukkula3,4, Anne Salonen3,5, Mika Gissler6,7, Hannele Laivuori8,9,10, Tuomas T Huttunen3,11, Kati Tihtonen8,9. 1. Department of Obstetrics and Gynecology, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland. maiju.kekki@pshp.fi. 2. Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. maiju.kekki@pshp.fi. 3. Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. 4. Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland. 5. Department of Pediatric and Adolescent Surgery, Tampere University Hospital, Tampere, Finland. 6. Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland. 7. Department of Molecular Medicine and Surgery, Karolinska Institute and Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden. 8. Department of Obstetrics and Gynecology, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland. 9. Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. 10. Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland. 11. Tampere University Heart Hospital, Tampere University Hospital, Tampere, Finland.
Abstract
PURPOSE: Previous studies have examined the optimal mode of breech delivery extensively, but there is a scarcity of publications focusing on the birth injuries of neonates born in breech presentation. This study aimed to examine birth injury in breech deliveries. METHODS: In this retrospective register-based nationwide cohort study, data on birth injuries in vaginal breech deliveries with singleton live births were compared to cesarean section with breech presentation and cephalic vaginal delivery between 2004 and 2017 in Finland. The data were retrieved from the National Medical Birth Register. Primary outcome variables were severe and mild birth injury. Incidences of birth injuries in different gestational ages and birthweights were calculated in different modes of delivery. Crude odds ratios of risk factors for severe birth injury were analyzed. RESULTS: In vaginal breech delivery (n = 4344), there were 0.8% of neonates with severe birth injury and 1.5% of neonates with mild birth injury compared to 0.06% and 0.2% in breech cesarean section (n = 16,979) and 0.3% and 1.9% in cephalic vaginal delivery (n = 629,182). Brachial plexus palsy was the most common type of injury in vaginal breech delivery. Increasing gestational age and birthweight had a stronger effect on the risk for injury among cephalic vaginal deliveries than among vaginal breech deliveries. CONCLUSION: Birth injuries were rare in vaginal breech deliveries. The incidence of severe birth injury was two times higher in vaginal breech delivery compared to cephalic vaginal delivery. Brachial plexus palsy was the most common type of injury in vaginal breech delivery.
PURPOSE: Previous studies have examined the optimal mode of breech delivery extensively, but there is a scarcity of publications focusing on the birth injuries of neonates born in breech presentation. This study aimed to examine birth injury in breech deliveries. METHODS: In this retrospective register-based nationwide cohort study, data on birth injuries in vaginal breech deliveries with singleton live births were compared to cesarean section with breech presentation and cephalic vaginal delivery between 2004 and 2017 in Finland. The data were retrieved from the National Medical Birth Register. Primary outcome variables were severe and mild birth injury. Incidences of birth injuries in different gestational ages and birthweights were calculated in different modes of delivery. Crude odds ratios of risk factors for severe birth injury were analyzed. RESULTS: In vaginal breech delivery (n = 4344), there were 0.8% of neonates with severe birth injury and 1.5% of neonates with mild birth injury compared to 0.06% and 0.2% in breech cesarean section (n = 16,979) and 0.3% and 1.9% in cephalic vaginal delivery (n = 629,182). Brachial plexus palsy was the most common type of injury in vaginal breech delivery. Increasing gestational age and birthweight had a stronger effect on the risk for injury among cephalic vaginal deliveries than among vaginal breech deliveries. CONCLUSION: Birth injuries were rare in vaginal breech deliveries. The incidence of severe birth injury was two times higher in vaginal breech delivery compared to cephalic vaginal delivery. Brachial plexus palsy was the most common type of injury in vaginal breech delivery.
Authors: L A Bergenhenegouwen; L J E Meertens; J Schaaf; J G Nijhuis; B W Mol; M Kok; H C Scheepers Journal: Eur J Obstet Gynecol Reprod Biol Date: 2013-10-16 Impact factor: 2.435
Authors: Janet Lyons; Tracy Pressey; Sharon Bartholomew; Shiliang Liu; Robert M Liston; K S Joseph Journal: Obstet Gynecol Date: 2015-05 Impact factor: 7.661
Authors: Maiju Kekki; Anne Salonen; Kati Tihtonen; Ville M Mattila; Mika Gissler; Tuomas T Huttunen Journal: Acta Paediatr Date: 2020-04-13 Impact factor: 2.299