Association Between Mode of Delivery of the Breech Fetus and Hospitalizations Due to Inflammatory Bowel Disease During Childhood.

Abstract

BACKGROUND AND GOALS:

While evidence suggests short-term benefits in neonatal morbidity and mortality from cesarean delivery of the fetus in breech presentation, the long-term implications for the offspring are less clear. To assess the implications of the mode of delivery on offspring's health, we have evaluated the long-term gastrointestinal (GI) morbidity of offspring with a breech presentation delivered in either way.

MATERIALS AND METHODS:

A population-based retrospective cohort study including singleton deliveries in breech presentation occurring between 1991 and 2014 at a tertiary referral hospital. Incidence of hospitalizations of the offspring up to the age of 18 years involving GI morbidity was compared between those delivered via cesarean section or vaginally. A Kaplan-Meier survival curve compared cumulative GI morbidity. A Weibull parametric survival model controlled for confounders while accounting for repeated occurrence of mothers and dependence among siblings.

RESULTS:

Overall, 86.9% (n=6376) of the 7337 fetuses in breech presentation, were delivered abdominally. Hospitalizations involving GI morbidity were higher in offspring delivered by cesarean section, specifically due to inflammatory bowel disease (IBD). Kaplan-Meier survival curve revealed the higher cumulative incidence of total GI morbidity and IBD specifically in the cesarean delivery group (P<0.001 and P=0.004, respectively). Using a Weibull parametric while controlling for relevant confounders, cesarean delivery emerged as an independent risk factor for long-term IBD-related morbidity of the offspring delivered in breech presentation (adjusted hazard ratio=3.18, 95% confidence interval: 1.47-6.87, P=0.003).

CONCLUSION:

Cesarean delivery is associated with higher rates of hospitalizations due to IBD and total GI morbidity during childhood in term singleton in breech presentation.

• Authors: Omri Zamstein, Ahinoam Glusman Bendersky, Eyal Sheiner, Daniella Landau, Amalia Levy
• Journal: Journal of clinical gastroenterology (J Clin Gastroenterol) Vol. 56 Issue 2 Pg. e161-e165 (02 01 2022) ISSN: 1539-2031 [Electronic] United States
• PMID: 34049380 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Topics

• Adolescent
• Cesarean Section
• Delivery, Obstetric
• Female
• Fetus
• Hospitalization
• Humans
• Infant, Newborn
• Inflammatory Bowel Diseases (epidemiology)
• Pregnancy
• Retrospective Studies