Breech presentation at delivery: a marker for congenital anomaly?
Breech presentation at delivery: a marker for congenital anomaly?
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DOI：
10.1038/jp.2013.132
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发表时间：
2014-01-01
影响因子：
2.9
通讯作者：
Leet, T. L.
中科院分区：
文献类型：
--
作者：
Mostello, D.;Chang, J. J.;Leet, T. L.
目的：为了确定是否先天性异常与臀位在birth.Study设计：一个人口为基础的，回顾性队列研究进行了460 - 147单胎活产妇女使用的密苏里州出生缺陷登记处，其中包括所有的缺陷诊断在第一年的生活。采用卡方统计和Student t检验比较臀位和头位分娩组的产妇和产科特征及结局。使用多变量二元逻辑回归分析来估计调整后的比值比（aOR）和95%置信区间（CI）。结果：无论是足月婴儿（9.4 vs 4.6%）还是早产婴儿（20.1 vs 11.6%），出生时臀位婴儿（11.7%）比头位婴儿（5.1%）更有可能存在至少一种先天性畸形。臀位与先天性畸形的关系在足月儿中较强（aOR 2.09，CI 1.96，2.23，足月vs 1.40，CI 1.26，1.55，早产），但并非在所有类型的畸形中。结论：分娩时臀位是先天性畸形存在的标志。臀位分娩的婴儿应特别检查是否存在畸形。
OBJECTIVE: To determine whether congenital anomalies are associated with breech presentation at the time of birth.STUDY DESIGN: A population-based, retrospective cohort study was conducted among 460 147 women with singleton live births using the Missouri Birth Defects Registry, which includes all defects diagnosed during the first year of life. Maternal and obstetric characteristics and outcomes between breech and cephalic presentation groups were compared using chi(2)-square statistic and Student's t-test. Multivariable binary logistic regression analysis was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).RESULT: At least one congenital anomaly was more likely present among infants breech at birth (11.7%) than in those with cephalic presentation (5.1%), whether full-term (9.4 vs 4.6%) or preterm (20.1 vs 11.6%). The relationship between breech presentation and congenital anomaly was stronger among full-term births (aOR 2.09, CI 1.96, 2.23, term vs 1.40, CI 1.26, 1.55, preterm), but not in all categories of anomalies.CONCLUSION: Breech presentation at delivery is a marker for the presence of congenital anomaly. Infants delivered breech deserve special scrutiny for the presence of malformation.