{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:32:51Z","timestamp":1789788771880,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association of vaginal versus caesarean birth with neonatal and maternal outcomes for breech, singleton deliveries at 22 0\/7 to 25 6\/7\u2009weeks of gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Hospital births in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>This study analysed non\u2010anomalous, singleton, breech live births at 22 0\/7 to 25 6\/7\u2009weeks of gestation identified in the linked birth\u2010infant death records data from 2016 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A propensity score analysis was conducted to establish pseudo\u2010randomization based on the mode of delivery, matching vaginal to caesarean deliveries at a ratio of 1:2 using greedy nearest\u2010neighbour matching. The propensity score estimation included year of delivery, maternal age, race\/ethnicity, pre\u2010pregnancy body mass index, parity, marital status, maternal education, insurance status, attendant at delivery, smoking status, hypertensive disorders, diabetes mellitus, gestational age, induction of labour and whether a trial of labour was attempted. We estimated the risk differences (RD) and odds ratios (OR) and associated 95% CIs, taking the matching into consideration. Multiple imputation was used to account for missing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Composite adverse neonatal and maternal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 21,461 periviable breech singleton births, 34.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097289) were delivered vaginally. The median gestational age was 24 (IQR: 23\u201325) and 23 (IQR: 22\u201324) weeks in the vaginal and caesarean delivery groups, respectively. Earlier gestational age was associated with vaginal birth, while later gestational age was associated with caesarean births. After propensity score matching, the distributions of baseline factors, except for gestational age, were balanced between the vaginal and caesarean delivery groups. A composite of adverse neonatal outcomes occurred among 99.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097213) of vaginal and 96.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913,716) of caesarean breech births (aRD 1.8%, 95% CI 1.3 to 2.4; aOR 2.25, 95% CI 1.59 to 3.17). Neonatal mortality rates were higher among vaginal compared to caesarean breech births (72.6% versus 36.2%; aRD 26.8%, 95% CI 25.0 to 28.6; aOR 3.15, 95% CI 2.85 to 3.48). A composite of adverse maternal outcomes occurred in 1.6% of vaginal breech and 3.1% of caesarean births (aRD \u22121.7%, 95% CI \u22122.2 to \u22121.1; aOR 0.47, 95% CI 0.35 to 0.63).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vaginal breech birth between 22 0\/7 and 25 6\/7\u2009weeks of gestation is associated with a lower risk of adverse maternal outcomes but a higher risk of neonatal adverse outcomes and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70067","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T06:42:03Z","timestamp":1761288123000},"page":"942-955","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes Among Vaginal Versus Caesarean Periviable Breech Deliveries: A Propensity Score\u2013Matched Study"],"prefix":"10.1111","volume":"133","author":[{"given":"Helen B.","family":"Gomez Slagle","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Columbia University, Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongmei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University, Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0410-2595","authenticated-orcid":false,"given":"Cande V.","family":"Ananth","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences Rutgers Robert Wood Johnson Medical School  New Brunswick New Jersey USA"},{"name":"Department of Biostatistics and Epidemiology Rutgers School of Public Health  Piscataway New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma M.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Columbia University, Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Julie","family":"Trahan","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Columbia University, Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-0824","authenticated-orcid":false,"given":"Alexander M.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Columbia University, Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002352"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000243"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.05.040"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.23580"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1605566"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.03.006"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70386-7"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.10.017"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.12.038"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.06.023"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.03.002"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1631792"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2019.02.015"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010020\u201004630\u20109"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010024\u201007826\u20102"},{"key":"e_1_2_12_17_1","unstructured":"\u201cThe Centers for Disease Control and Prevention. Revisions of the U.S. Standard Certificates and Reports. Available at: The Centers for Disease Control and Prevention. Revisions of the U.S. Standard Certificates and Reports. Available at: The Centers for Disease Control and Prevention. Revisions of the U.S. Standard Certificates and Reports \u201d(2024) https:\/\/www.cdc.gov\/nchs\/nvss\/revisions\u2010of\u2010the\u2010us\u2010standard\u2010certificates\u2010and\u2010reports.htm."},{"key":"e_1_2_12_18_1","volume-title":"Methodological Issues and the 2003 Revision of Standard Instruments","author":"National Research Council (US) Committee on National Statistics","year":"2009"},{"key":"e_1_2_12_19_1","unstructured":"National Center for Health Statistics Division of Vital Statistics \u201cUser Guide to the 2021 Period\/2020 Cohort Linked Birth\/Infant Death Public Use File. Accessed May 7 2024. Available at: National Center for Health Statistics Division of Vital Statistics. 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User Guide to the 2021 Period\/2020 Cohort Linked Birth\/Infant Death Public Use File \u201d(2024) https:\/\/ftp.cdc.gov\/pub\/Health_Statistics\/NCHS\/Dataset_Documentation\/DVS\/period\u2010cohort\u2010linked\/21PE20CO_linkedUG.pdf."},{"key":"e_1_2_12_20_1","unstructured":"Statistics Division of Vital Statistics \u201cUser Guide to the 2021 Natality Public Use File \u201d(2024) https:\/\/ftp.cdc.gov\/pub\/Health_Statistics\/NCHS\/Dataset_Documentation\/DVS\/natality\/UserGuide2021.pdf."},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280206074463"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470316696"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015\u20102336"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200210000-00003"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318273695b"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200211000-00021"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.516287"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70067","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.70067","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:48:52Z","timestamp":1775710132000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.70067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/1471-0528.70067"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.70067","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]},"assertion":[{"value":"2025-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}