American Journal of Obstetrics & Gynecology
Volume 199, Issue 1 , Pages 59.e1-59.e8, July 2008

Population trends in cesarean delivery for breech presentation in the United States, 1997-2003

Presented at the annual meeting of the Pediatric Academic Societies, Toronto, ON, Canada, May 5-8, 2007.

  • Henry Chong Lee, MD, MS

      Affiliations

    • Department of Pediatrics, Perinatal Epidemiology, and Health Outcomes Research Unit, Stanford University, Stanford, CA
    • Corresponding Author InformationReprints: Henry Chong Lee, MD, Division of Neonatal and Developmental Medicine, Stanford University, 750 Welch Rd, Suite 315, Stanford, CA 94304.
    • ,
  • Yasser Y. El-Sayed, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Stanford University, Stanford, CA.
    • ,
  • Jeffrey B. Gould, MD, MPH

      Affiliations

    • Department of Pediatrics, Perinatal Epidemiology, and Health Outcomes Research Unit, Stanford University, Stanford, CA

Received 31 May 2007; received in revised form 29 August 2007; accepted 27 November 2007. published online 25 February 2008.

Objective

The objective of the study was to determine whether cesarean delivery for breech has increased in the United States.

Study Design

We calculated cesarean rates for term singletons in breech/malpresentation from 1997 to 2003 using National Center for Health Statistics data. We compared rates by sociodemographic groups and state. Multivariable logistic regression models were constructed to see whether factors associated with cesarean delivery differed over time.

Results

Breech cesarean rates increased overall from 83.8% to 85.1%. There was a significant increase in rates for most sociodemographic groups. There was little to no increase for mothers younger than 30 years old. There was wide variability in rates by state, 61.6-94.2% in 1997. Higher breech incidence correlated with lower cesarean rates, suggesting potential state bias in reporting breech.

Conclusion

In the United States, breech infants are predominantly born by cesarean. There was a small increase in this trend from 1998 to 2002. There is wide variability by state, which is not explained by sociodemographic patterns and may be due to reporting differences.

Key words: breech, cesarean delivery, malpresentation, United States

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 This study was supported by National Institutes of Health Training Grant 2T32 HD 07249-23 (to H.C.L.).Cite this article as: Lee HC, El-Sayed YY, Gould JB. Population trends in cesarean delivery for breech presentation in the United States, 1997-2003. Am J Obstet Gynecol 2008;199:59.e1-59.e8.

PII: S0002-9378(07)02241-7

doi:10.1016/j.ajog.2007.11.059

American Journal of Obstetrics & Gynecology
Volume 199, Issue 1 , Pages 59.e1-59.e8, July 2008

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