ArticleAmerican journal of obstetrics and gynecology2015
Morbidity and mortality associated with mode of delivery for breech periviable deliveries.
Article in American journal of obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Composite neonatal morbidity indicators using hospital discharge data: A systematic review.Paediatric and perinatal epidemiology · 2020Pooled it
- What is the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs? A systematic review and meta-analyses.BMC pregnancy and childbirth · 2017Pooled it
- Modelling factors associated with infant mortality in Northern Region of Ghana: survival analysis approach.BMC public health · 2026Article
- Association of Intended Mode of Delivery With Neonatal and Maternal Outcomes at 22-25 Weeks of Gestation.O&G open · 2026Article
- En caul cesarean section for extremely low birth weight infants: a single-center, retrospective study.BMC pregnancy and childbirth · 2025Article
- Considerations for obstetric management of births 22-25 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Mode of delivery and outcomes among inborn extremely preterm singletons: A cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Observational
- A nomogram for predicting the risk of Bronchopulmonary dysplasia in premature infants.Heliyon · 2023Article
- Ethical Dilemmas in Neonatal Care at the Limit of Viability.Children (Basel, Switzerland) · 2023Review
- Cesarean section was not associated with mortality or morbidities advantage in very low birth weight infants: a nationwide cohort study.Scientific reports · 2021Article
- Maternal morbidity by attempted route of delivery in periviable birth.The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2021Article
- Medications and in-hospital outcomes in infants born at 22-24 weeks of gestation.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- Do maternal characteristics influence maternal-fetal medicine physicians' willingness to intervene when managing periviable deliveries?Journal of perinatology : official journal of the California Perinatal Association · 2016Article
Corrections and comments
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- Commented on byReply.2016
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe purpose of this study was to estimate the odds of morbidity and death that are associated with cesarean delivery, compared with vaginal delivery, for breech fetuses who are delivered from 23-24 6/7 weeks' gestational age. STUDY
designWe conducted a retrospective cohort study of state-level maternal and infant hospital discharge data that were linked to vital statistics for breech deliveries that occurred from 23-24 6/7 weeks' gestation in California, Missouri, and Pennsylvania from 2000-2009 (N = 1854). Analyses were stratified by gestational age (23-23 6/7 vs 24-24 6/7 weeks' gestation).
resultsCesarean delivery was performed for 46% (335 fetuses) and 77% (856 fetuses) of 23- and 24-week breech fetuses. In multivariable analyses, overall survival was greater for cesarean-born neonates (adjusted odds ratio [AOR], 3.98; 95% confidence interval [CI], 2.24-7.06; AOR, 2.91; 95% CI, 1.76-4.81, respectively). When delivered for nonemergent indications, cesarean-born survivors were more than twice as likely to experience major morbidity (intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, asphyxia composite; AOR, 2.83; 95% CI, 1.37-5.84; AOR, 2.07; 95% CI, 1.11-3.86 at 23 and 24 weeks' gestation, respectively). Among intubated neonates, despite a short-term survival advantage, there was no difference in survival to >6-month corrected age (AOR, 1.77; 95% CI, 0.83-3.74; AOR, 1.50; 95% CI, 0.81-2.76, respectively). There was no difference in survival for intubated 23-week neonates who were delivered by cesarean for nonemergent indications or cesarean-born neonates who weighed <500 g.
conclusionCesarean delivery increased overall survival and major morbidity for breech periviable neonates. However, among intubated neonates, despite a short-term survival advantage, there was no difference in 6-month survival. Also, cesarean delivery did not increase survival for neonates who weighed <500 g. Patients and providers should discuss explicitly the trade-offs related to neonatal death and morbidity, maternal morbidity, and implications for future pregnancies.
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