Svenningsen N W, Westgren M, Ingemarsson I
J Perinat Med. 1985;13(3):117-26. doi: 10.1515/jpme.1985.13.3.117.
In a comprehensive 4-year follow-up study the long-term outcomes in 709 singleton term breech born infants were evaluated. The outcome has been related to different management protocols during two consecutive study periods. In the first period (A, 1971-1974) the rate of cesarean section was 16.1% and in the second period (B, 1974-1977) 37.1%. The neonatal mortality rate was the same in both study periods (0.3%). The incidence of long-term neurodevelopmental handicaps was in period A 5.3% and in period B 2.4% at 4 years of age. Sequelae among infants in period A were in most cases labor-related, i.e. footling, extended arms or difficulty in descent of the fetal head. An antero-posterior diameter of less than 12 cm at the brim was common in these cases. In both study periods there was an increased risk of neurodevelopmental handicaps for infants with hyperextension of the head in the breech position delivered by the vaginal route. In period B the incidence of neurodevelopmental sequelae at the 4-year follow-up did not differ from that found in a group of infants born vaginally in vertex presentation. The rates of visual and auditory disorders, behaviour problems, enuresis and late speech development were not increased in the breeches neither in period A nor in period B.
在一项为期4年的全面随访研究中，对709名单胎足月儿出生时臀位的婴儿的长期结局进行了评估。该结局与两个连续研究期间的不同管理方案相关。在第一个时期（A，1971 - 1974年），剖宫产率为16.1%，在第二个时期（B，1974 - 1977年）为37.1%。两个研究期间的新生儿死亡率相同（0.3%）。4岁时，A期长期神经发育障碍的发生率为5.3%，B期为2.4%。A期婴儿的后遗症在大多数情况下与分娩相关，即足先露、手臂伸展或胎头下降困难。在这些病例中，骨盆入口前后径小于12 cm很常见。在两个研究期间，对于臀位时头部过度伸展经阴道分娩的婴儿，神经发育障碍的风险均增加。在B期，4年随访时神经发育后遗症的发生率与一组头先露经阴道分娩的婴儿没有差异。A期和B期臀位婴儿的视觉和听觉障碍、行为问题、遗尿和语言发育迟缓的发生率均未增加。
