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The preterm breech fetuses with adverse outcomes born vaginally or by emergency cesarean section were compared with the fetuses without adverse outcomes with the same gestational age. A multivariable logistic regression analysis was used to calculate the risk factors for adverse outcomes (umbilical arterial pH below 7, 5-min Apgar score below 4, intrapartum stillbirth and neonatal death\u2009&lt;\u200928\u00a0days of age).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Adverse outcome in vaginal preterm breech delivery was associated with maternal obesity (aOR 32.19, CI 2.97\u2013348.65), smoking (aOR 2.29, CI 1.12\u20134.72), congenital anomalies (aOR 4.50, 1.56\u201312.96), preterm premature rupture of membranes (aOR 1.87, CI 1.00\u20133.49), oligohydramnios (28\u201332\u00a0weeks of gestation: aOR 6.50, CI 2.00\u201321.11, 33\u201336\u00a0weeks of gestation: aOR 19.06, CI 7.15\u201350.85), epidural anesthesia in vaginal birth (aOR 2.44, CI 1.19\u20135.01), and fetal growth below the second standard deviation (28\u201332\u00a0weeks of gestation: aOR 5.89, CI 1.00\u201334.74, 33\u201336\u00a0weeks of gestation: aOR 12.27, CI 2.81\u201353.66).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The study shows that for each subcategory of preterm birth, there are different risk factors for adverse neonatal outcomes in planned vaginal breech delivery. Due to the extraordinary increased risk of adverse outcomes, we would recommend a planned cesarean section in very preterm breech presentation (28\u2009+\u20090 to 32\u2009+\u20096\u00a0weeks) with severe maternal obesity, oligohydramnios, or fetal growth restriction and in moderate to late preterm breech presentation (33\u2009+\u20090 to 36\u2009+\u20096\u00a0weeks) with oligohydramnios or fetal growth restriction.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-020-05731-y","type":"journal-article","created":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T04:10:57Z","timestamp":1596773457000},"page":"93-101","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Risk factors for adverse outcomes in vaginal preterm breech labor"],"prefix":"10.1007","volume":"303","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4812-2766","authenticated-orcid":false,"given":"Anna","family":"Toijonen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seppo","family":"Heinonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Macharey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,7]]},"reference":[{"issue":"4","key":"5731_CR1","first-page":"410","volume":"77","author":"S Albrechtsen","year":"1998","unstructured":"Albrechtsen S, Rasmussen S, Dalaker K, Irgens LM (1998) The occurrence of breech presentation in Norway 1967-1994. 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Toijonen declares that she has no conflict of interest. The author S. Heinonen declares that he has no conflict of interest. The author M. Gissler declares that he has no conflict of interest. The author G. Macharey declares that he has no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The register keeping organizations gave their permission to use their confidential health data in this study. No registered persons were contacted and thus, no consent for participant was needed. The Finnish Institute for Health and Welfare authorized to use the data (reference number THL\/652\/5.05.00\/2017).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"SAS custom code cannot be shared publicly, but it is available on request from Mika Gissler (mika.gissler@thl.fi).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}}]}}