Neonatal admission rate after vaginal breech delivery

Anne Dathan-Stumpf; Christina Hausmann; Ulrich Thome; Holger Stepan

doi:10.1515/jpm-2022-0202

Article

Neonatal admission rate after vaginal breech delivery

Anne Dathan-Stumpf , Christina Hausmann , Ulrich Thome and Holger Stepan

Published/Copyright: July 13, 2022

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From the journal Journal of Perinatal Medicine Volume 50 Issue 9

Abstract

Objectives

The safest mode of delivery for fetuses in breech presentations is still an ongoing debate. The aim of this study was to analyze neonatal admission rates after vaginal breech delivery and compare it to other modes of delivery in order to counsel pregnant women with breech presentation adequately.

Methods

We performed a retrospective monocentric analysis of all deliveries with singleton pregnancies in breech presentation > 36.0 weeks of gestation between 01/2018–12/2019. Short-term neonatal morbidity data was collected for vaginal delivery and primary as well as secondary cesarean sections from breech presentations.

Results

A total of n=41/482 (8.5%) neonates had to be admitted to NICU: vaginal breech delivery n=18/153 (11.8%), primary cesarean section n=9/101 (8.9%, OR 0.73; CI 0.32–1.70; p=0.47), secondary cesarean section n=10/76 (13.2%, OR 1.14; CI 0.50–2.60, p=0.76) and vaginal vertex delivery n=4/152 (2.6%, OR 0.20; CI 0.06–0.51; p=0.005). There was no significant difference in transfer to NICU between all breech position delivery modes. Despite significantly lower pH and 5’ APGAR values after vaginal delivery, neonates delivered by primary cesarean section and NICU admission had to be treated there significantly longer (mean 80.9 vs. 174.0 h). No significant difference in terms of ventilation parameters and infections were found between the vaginal delivery, primary and secondary cesarean section from breech presentation.

Conclusions

Vaginal breech delivery does not result in a higher neonatal admission rate in comparison to primary and secondary section. In contrast, there is a shorter NICU duration in case of neonatal admission after vaginal delivery.

Keywords: breech presentation; delivery mode; neonatal short-term outcome; vaginal delivery

Corresponding author: Anne Dathan-Stumpf, MD, Department of Obstetrics, University Hospital, Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany, Phone: 0049 341 9723465, Fax: 0049 341 9723599, E-mail: anne.dathan-stumpf@medizin.uni-leipzig.de

Anne Dathan-Stumpf and Christina Hausmann contributed equally to this work as first-authors.

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Ethical Committee of the University of Leipzig (IRB00001750; registration number 449/21-ek).

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Received: 2022-01-28

Accepted: 2022-06-10

Published Online: 2022-07-13

Published in Print: 2022-11-25

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0202

Keywords for this article

breech presentation; delivery mode; neonatal short-term outcome; vaginal delivery