Transactions of the Twenty-Fourth Annual Meeting of the Society for Maternal-Fetal MedicineOutcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: The international randomized Term Breech Trial
Section snippets
Eligibility and randomization
Women were eligible for the trial if they had a singleton live fetus in a frank or complete breech presentation at term (≥37 weeks gestation). The study was approved by the research ethics committees at participating centers, and women gave informed consent before being enrolled in the study. Eligible and consenting women were then allocated randomly, with a centralized randomization service, to either the planned cesarean or the planned vaginal birth groups. Babies in breech presentation who
Results
The Term Breech Trial enrolled 2088 women between January 9, 1997, and April 21, 2000, at 121 centers in 26 countries. In 85 centers in 18 countries, 1159 (55.5%) children participated in the 2-year follow-up, of which 580 children were assigned to the planned cesarean birth group, and 579 children were assigned to the planned vaginal birth group (Figure). We received follow-up information for 923 of these children (79.6%), of which 457 children were in the planned cesarean birth group and 466
Comment
This is the first report of a randomized controlled trial that compares the policies of planned cesarean birth and planned vaginal birth for breech presentation at term in terms of outcomes of children at 2 years of age. Planned cesarean birth did not reduce the risk of death or neurodevelopmental delay at 2 years of age, compared with planned vaginal birth. This is in contrast to our earlier report that found a marked reduction in the risk of perinatal or neonatal death or serious neonatal
Acknowledgments
We thank the parents of the 920 children who participated in the 2-year follow-up of the Term Breech Trial and Jennifer Marsh, Laurie Kilburn, Shelley Stalker, Julie Weston, and Tanya Webb.
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Supported by a grant from the Canadian Institutes of Health Research (grant no. MT-37415). The Data Co-ordination Centre was supported by grants from the Centre for Research in Women's Health, Sunnybrook and Women's College Health Sciences Centre, and the Department of Obstetrics and Gynaecology at the University of Toronto, Toronto, Ontario, Canada.
Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal Fetal Medicine, New Orleans, La, February 2-7, 2004.
Reprints will not be available from the authors.