Cesarean section in term breech presentations: do rates of adverse neonatal outcomes differ by hospital birth volume?
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Christine Hoehner
Abstract
Aim: To determine if risk of adverse neonatal outcomes among term breech infants delivered by cesarean section differs by volume of such births at the delivering hospital.
Methods: We conducted a population-based cohort study using Missouri linked birth and death certificate files. The study population included 10,106 singleton, term, normal birth weight infants in breech presentation delivered by cesarean section. Infants were linked to hospitals where delivered. These hospitals were divided into terciles (low, medium, and high volume) based on the median number of annual deliveries during 1993–1999. The primary outcome was presentation of at least one adverse neonatal outcome. Adjusted odds ratios and 95% confidence intervals (CI) were calculated using logistic regression analysis
Results: The rate of any adverse outcome was 17.8, 15.0, and 5.9 cases per 1,000 deliveries at low-, medium-, and high-volume hospitals, respectively. All component adverse outcomes occurred more frequently in low- or medium-volume hospitals than in high-volume hospitals. Compared to breech infants delivered at high-volume hospitals, those delivered at low-volume and medium-volume hospitals were 2.7 (CI 1.6, 4.5) and 2.4 (CI 1.4, 4.1) times, respectively, more likely to experience an adverse outcome after adjusting for significant confounders.
Conclusions: Prospective studies should explore the source of these risk differences.
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©2006 by Walter de Gruyter Berlin New York
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Artikel in diesem Heft
- The chemical erosion of human health: adverse environmental exposure and in-utero pollution – determinants of congenital disorders and chronic disease
- Cesarean section in term breech presentations: do rates of adverse neonatal outcomes differ by hospital birth volume?
- Antibiotic therapy for preterm premature rupture of membranes – results of a multicenter study
- Relation between grief and subsequent pregnancy status 13 months after perinatal bereavement
- Vaginal birth after cesarean section: X-ray pelvimetry at term is informative
- Vaginal birth after cesarean section: X-ray pelvimetry at term is informative
- Dilatation of the abdominal umbilical vein is associated with increased risk of thrombotic complications
- Retrospective diagnosis of hypoxic myocardial injury in premature newborns
- Fetal brain injury in experimental intrauterine asphyxia and inflammation in Göttingen minipigs
- Intrauterine growth restriction induces increased capillary density and accelerated type I fiber maturation in newborn pig skeletal muscles
- Closing arguments for gastroschisis: management with silo reduction
- Mean platelet and red blood cell volume measurements to estimate the severity of hypertension in pregnancy
- Torsion of a pedunculated accessory hepatic lobe: differential diagnosis of projectile vomiting in a neonate
- Massive fetomaternal hemorrhage following failed external cephalic version: case report
- Resolution of peripheral tissue ischemia secondary to arterial vasospasm following treatment with a topical nitroglycerin device in two newborns: case reports
- Echocardiography and N-terminal pro BNP
- Frontal-dominant white matter lesions following congenital rubella and cytomegalovirus infection
- Perinatal Programming
- Congress Calendar
