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

Hilary Whyte, Mary E Hannah, Saroj Saigal, Walter J Hannah, Sheila Hewson, Kofi Amankwah, Mary Cheng, Amiram Gafni, Patricia Guselle, Michael Helewa, Ellen D Hodnett, Eileen Hutton, Rose Kung, Darren McKay, Susan Ross, Andrew Willan
American Journal of Obstetrics and Gynecology 2004, 191 (3): 864-71

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 > or =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.

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