Mackay, D. F. , Wood, R., King, A., Clark, D. N., Cooper, S.-A. , Smith, G. C.S. and Pell, J. P. (2015) Educational outcomes following breech delivery: a record-linkage study of 456947 children. International Journal of Epidemiology, 44(1), pp. 209-217. (doi: 10.1093/ije/dyu270) (PMID:25613426)
Full text not currently available from Enlighten.
Abstract
Background: Obstetric management of term breech infants changed dramatically following the Term Breech Trial which suggested increased serious neonatal morbidity following trial of labour. Short-term morbidity is a poor proxy of long-term neurological sequelae. We determined whether vaginal breech delivery was associated with educational outcomes.<p></p> Methods: We linked three Scotland-wide administrative databases at an individual level: the ScotXed school census; Scottish Qualifications Authority (SQA) examination results; and Scottish Morbidity Record (SMR02) maternity database. The linkage provided information on singleton children, born at term, attending Scottish schools between 2006 and 2011.<p></p> Results: Of the 456 947 eligible children, 1574 (0.3%) had vaginal breech deliveries, 12 489 (2.7%) planned caesarean section for breech presentation and 442 090 (96.9%) vaginal cephalic deliveries. The percentage of term breech infants delivered vaginally fell from 23% to 7% among children who started school in 2006 and 2011, respectively. Of children born by vaginal breech delivery, 1.5% had a low 5-min Apgar score (≤3) compared with only 0.4% of those born by either breech caesarean section [adjusted odds ratio (OR) 6.16, 95% confidence interval (CI) 4.44–8.54, p < 0.001] or cephalic vaginal delivery (adjusted OR 3.84, 95% CI 2.99–4.93, p < 0.001). Children born by vaginal breech delivery had lower examination attainment than those born by either planned caesarean section for breech presentation (adjusted OR 1.16, 95% CI 1.02–1.32, p = 0.020) or vaginal cephalic delivery (adjusted OR 1.14, 95% CI 1.01–1.28, p = 0.029).<p></p> Conclusions: Vaginal delivery of term breech infants was associated with lower examination attainment, as well as poorer Apgar scores, suggesting that the adverse effects are not just short-term.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Cooper, Professor Sally-Ann and Pell, Professor Jill and Mackay, Professor Daniel |
| Authors: | Mackay, D. F., Wood, R., King, A., Clark, D. N., Cooper, S.-A., Smith, G. C.S., and Pell, J. P. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing |
| Journal Name: | International Journal of Epidemiology |
| Publisher: | Oxford University Press |
| ISSN: | 0300-5771 |
| ISSN (Online): | 1464-3685 |
University Staff: Request a correction | Enlighten Editors: Update this record
Altmetric
Altmetric