Title :

Planned delivery route of preterm breech singletons and neonatal and 2-year outcomes: a population-based cohort study

Author(s) :

Lorthe, Elsa [Auteur]
Sentilhes, Loic [Auteur]
Quere, Mathilde [Auteur]
Lebeaux, Cécile [Auteur]
Winer, Norbert [Auteur]
Torchin, Heloise [Auteur]
Goffinet, François [Auteur]
Delorme, Pierre [Auteur]
Kayem, Gilles [Auteur]

Journal title :

BJOG . an international journal of obstetrics and gynaecology

Abbreviated title :

BJOG

Publication date :

2018-09-14

ISSN :

1471-0528

English keyword(s) :

EPIPAGE-2
prematurity
delivery route
mode of delivery
neonatal outcomes
cerebral palsy
vaginal delivery
neurosensory impairment
Breech
caesarean

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: To assess whether planned route of delivery is associated with perinatal and 2-year outcomes for preterm breech singletons. METHODS: Prospective nationwide population-based EPIPAGE-2 cohort study. METHODS: France, ...
Show more >OBJECTIVE: To assess whether planned route of delivery is associated with perinatal and 2-year outcomes for preterm breech singletons. METHODS: Prospective nationwide population-based EPIPAGE-2 cohort study. METHODS: France, 2011. METHODS: Three hundred and ninety women with breech singletons born at 26-34 weeks of gestation after preterm labour or preterm prelabour rupture of membranes. METHODS: Propensity-score analysis. METHODS: Survival at discharge, survival at discharge without severe morbidity, and survival at 2 years of corrected age without neurosensory impairment. RESULTS: Vaginal and caesarean deliveries were planned in 143 and 247 women, respectively. Neonates with planned vaginal delivery and planned caesarean delivery did not differ in survival (93.0 versus 95.7%, P = 0.14), survival at discharge without severe morbidity (90.4 versus 89.9%, P = 0.85), or survival at 2 years without neurosensory impairment (86.6 versus 91.6%, P = 0.11). After applying propensity scores and assigning inverse probability of treatment weighting, as compared with planned vaginal delivery, planned caesarean delivery was not associated with improved survival (odds ratio, OR 1.31; 95% confidence interval, 95% CI 0.67-2.59), survival without severe morbidity (OR 0.75, 95% CI 0.45-1.27), or survival at 2 years without neurosensory impairment (OR 1.04, 95% CI 0.60-1.80). Results were similar after matching on propensity score. CONCLUSIONS: No association between planned caesarean delivery and improved outcomes for preterm breech singletons born at 26-34 weeks of gestation after preterm labour or preterm prelabour rupture of membranes was found. The route of delivery should be discussed with women, balancing neonatal outcomes with the higher risks of maternal morbidity associated with caesarean section performed at low gestational age.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T18:19:42Z