Time trend in the risk of delivery-related perinatal and neonatal death associated with breech presentation at term

被引:19
|
作者
Pasupathy, Dharmintra
Wood, Angela M. [2 ]
Pell, Jill P. [3 ]
Fleming, Michael [4 ]
Smith, Gordon C. S. [1 ]
机构
[1] Univ Cambridge, Dept Obstet & Gynaecol, NIHR Cambridge Comprehens Biomed Res Ctr, Cambridge CB2 2QQ, England
[2] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge CB1 8RN, England
[3] Univ Glasgow, Publ Hlth Sect, Glasgow G12 8RZ, Lanark, Scotland
[4] Common Serv Agcy, Informat & Stat Div, Edinburgh EH5 3SE, Midlothian, Scotland
基金
英国医学研究理事会;
关键词
Perinatal death; cause of death; time trends; breech pregnancies; CESAREAN DELIVERY; TRIAL; NETHERLANDS; MORTALITY; SECTION; BIRTH; LABOR;
D O I
10.1093/ije/dyn225
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background To determine the factors associated with the risk of delivery-related perinatal and neonatal death among term infants presenting by the breech and the effect of changes in the mode of delivery on the overall rates of perinatal and neonatal mortality associated with breech presentation. Methods We studied 32 776 singleton term infants presenting breech excluding anomalous and antepartum losses in Scotland between 1985 and 2004, using linked Scottish national registries of pregnancy outcome data and perinatal death data. The event was delivery-related perinatal and neonatal death (i.e. intrauterine fetal death during labour or death of infant in the first 4 weeks of life), subdivided according to intrapartum anoxia or mechanical cause of death. Analysis was by multivariate logistic regression. Results During the study period, the risk of delivery-related perinatal and neonatal death decreased by 72 (95 CI 1 to 93), due to a 90 (95 CI 3399) reduction in anoxic or mechanical deaths. Both intrapartum (OR 0.16, 95 CI 0.020.75) and planned (OR 0.01, 95 CI 0.000.09) caesarean delivery were protective against anoxic or mechanical deaths and increased use of planned caesarean delivery accounted for 16 of the decline in anoxic and mechanical deaths over the study period. Conclusion Increased use of planned caesarean delivery only partly explains the decline in delivery-related perinatal and neonatal death between 1985 and 2004 in Scotland.
引用
收藏
页码:490 / 498
页数:9
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