Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: The international randomized Term Breech Trial
Objective
The purpose of this study was to determine whether planned cesarean delivery for the singleton fetus in breech presentation at term reduces the risk of death or neurodevelopmental delay at 2 years of age.
Study design
In selected centers in the Term Breech Trial, children were screened for abnormalities at ≥2 years of age with the Ages and Stages Questionnaire, followed by a neurodevelopmental assessment if the Ages and Stages Questionnaire score was abnormal.
Results
A total of 923 of 1159 children (79.6%) from 85 centers were followed to 2 years of age. The risk of death or neurodevelopmental delay was no different for the planned cesarean than for the planned vaginal birth groups (14 children [3.1%] vs 13 children [2.8%]; relative risk, 1.09; 95% CI, 0.52- 2.30; P=.85; risk difference, +0.3%; 95% CI, −1.9%, +2.4%).
Conclusion
Planned cesarean delivery is not associated with a reduction in risk of death or neurodevelopmental delay in children at 2 years of age.
jMcMaster University Hamilton, Ontario, Canada, and Department of Obstetrics and Gynaecology, St Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada
Supported by a grant from the Canadian Institutes of Health Research (grant no. MT-37415). The Data Co-ordination Centre was supported by grants from the Centre for Research in Women's Health, Sunnybrook and Women's College Health Sciences Centre, and the Department of Obstetrics and Gynaecology at the University of Toronto, Toronto, Ontario, Canada.
Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal Fetal Medicine, New Orleans, La, February 2-7, 2004.
ABSTRACT