Birth weight and neurodevelopmental outcome of children at 2 years of age after planned vaginal delivery for breech presentation at term.

Abstract

The purpose of this prospective cohort study was to determine whether planned vaginal delivery for the term singleton baby in breech position increases the risk of abnormal neurodevelopment at 2 years of age and to assess whether the effect is modified by birth weight. At 2 years of age, all nonrandomized children born in breech position during our participation in the Term Breech Trial were screened for abnormal neurodevelopment with the Ages and Stages Questionnaire. An Ages and Stages Questionnaire at 2 years of age was obtained in 183 of 203 children (90.1%). Twenty-eight percent of these children showed 1 or more abnormal Ages and Stages Questionnaire domains. There were no differences in the risk of having abnormal Ages and Stages Questionnaire domains between planned vaginal delivery and planned cesarean section (P = .99). There was, however, evidence of interaction between mode of delivery and birth weight, with significantly higher risk in neurodevelopmental delay in children with birth weight greater than 3500 g with planned vaginal birth (adjusted odds ratio for interaction term 3.37; 95% confidence interval 1.14 to 9.95). Based on the Ages and Stages Questionnaire results at 2 years of age, planned vaginal delivery is associated with an increased risk of neurodevelopmental delay at 2 years of age in term breech children with a birth weight greater than 3500 g.