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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Reiss, Irwin / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

9 Issues per year


IMPACT FACTOR 2016: 1.577
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CiteScore 2016: 1.49

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Source Normalized Impact per Paper (SNIP) 2016: 0.832

Online
ISSN
1619-3997
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Volume 34, Issue 3 (May 2006)

Issues

Cesarean section in term breech presentations: do rates of adverse neonatal outcomes differ by hospital birth volume?

Christine Hoehner
  • Department of Community Health, St. Louis University School of Public Health, St. Louis, Missouri, USA
  • Other articles by this author:
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/ Amy Kelsey / Nermeen El-Beltagy
  • Department of Community Health, St. Louis University School of Public Health, St. Louis, Missouri, USA
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/ Raul Artal
  • Department of Community Health, St. Louis University School of Public Health, St. Louis, Missouri, USA
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  • De Gruyter OnlineGoogle Scholar
/ Terry Leet
  • Department of Obstetrics, Gynecology, and Women's Health, St. Louis University School of Medicine, St. Louis, Missouri, USA
  • Other articles by this author:
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Published Online: 2006-04-07 | DOI: https://doi.org/10.1515/JPM.2006.034

Abstract

Aim: To determine if risk of adverse neonatal outcomes among term breech infants delivered by cesarean section differs by volume of such births at the delivering hospital.

Methods: We conducted a population-based cohort study using Missouri linked birth and death certificate files. The study population included 10,106 singleton, term, normal birth weight infants in breech presentation delivered by cesarean section. Infants were linked to hospitals where delivered. These hospitals were divided into terciles (low, medium, and high volume) based on the median number of annual deliveries during 1993–1999. The primary outcome was presentation of at least one adverse neonatal outcome. Adjusted odds ratios and 95% confidence intervals (CI) were calculated using logistic regression analysis

Results: The rate of any adverse outcome was 17.8, 15.0, and 5.9 cases per 1,000 deliveries at low-, medium-, and high-volume hospitals, respectively. All component adverse outcomes occurred more frequently in low- or medium-volume hospitals than in high-volume hospitals. Compared to breech infants delivered at high-volume hospitals, those delivered at low-volume and medium-volume hospitals were 2.7 (CI 1.6, 4.5) and 2.4 (CI 1.4, 4.1) times, respectively, more likely to experience an adverse outcome after adjusting for significant confounders.

Conclusions: Prospective studies should explore the source of these risk differences.

Keywords: Breech presentation; cesarean section; hospital birth volume; neonatal outcomes

About the article

Corresponding author: Raul Artal, MD Professor and Chairman Department of Obstetrics, Gynecology and Women's Health St. Louis University School of Medicine 6420 Clayton Road, Suite 290 St. Louis, MO 63117/USA


Received: November 20, 2005

Accepted: January 24, 2006

Published Online: 2006-04-07

Published in Print: 2006-05-01


Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2006.034.

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