{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T22:00:40Z","timestamp":1766268040506,"version":"3.32.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T00:00:00Z","timestamp":1731110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Optimal counseling of women for vaginal breech birth requires consideration of both established and emerging risk factors for adverse perinatal outcomes. Currently, rising prevalences of maternal obesity and impaired glucose tolerance challenge obstetric care. We aimed to investigate the effects of these parameters on the outcome of vaginal breech birth to improve counseling practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A total of 361 women (without previous vaginal births) attending vaginal birth of a singleton fetus in breech presesntation between 01\/2015 and 11\/2021 were included in this retrospective single\u2010center study. Data were derived from the hospital data base. We analyzed the effect of the maternal body mass index (BMI) at birth (compared to pre\u2010pregnancy BMI), excessive weight gain, gestational diabetes, and neonatal birthweight on obstetrical and neonatal short\u2010term outcomes (intrapartum cesarean delivery, performance of obstetric maneuvers (L\u00f8vset\u2010, Bracht\u2010, Veit\u2010Smellie maneuver and Bickenbach's arm delivery), admission to the neonatal unit, Apgar score after 5\u2009minutes\u00a0&lt;7, and arterial cord pH\u2010value &lt;7.10). Multivariable logistic regression was used for analysis and adjustment of variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 246 women (68.1%) had a successful vaginal birth. Intrapartum cesarean delivery (<jats:italic>n<\/jats:italic>\u2009=\u2009115\/361; 31.9%) was independently associated with maternal BMI at birth (<jats:italic>p<\/jats:italic>\u2009=\u20090.0283, aOR\u2009=\u20091.87 (1.19\u20133.97)) if birthweight was \u22653800\u2009g. The rate of intrapartum cesarean delivery was also higher in women with gestational diabetes (<jats:italic>p<\/jats:italic>\u2009=\u20090.0030, aOR = 10.83 (2.41\u201060.84)). A significantly higher risk of neonatal acidosis (arterial pH\u2010value &lt;7.10) was observed in women with BMI at birth \u226530\u2009kg\/m<jats:sup>2<\/jats:sup> (<jats:italic>p<\/jats:italic>\u2009=\u20090.0345, aOR\u2009=\u20091.84 (1.04\u20133.22)) without affecting other outcomes. Pre\u2010pregnancy BMI, gestational weight gain and BMI\u2010gain did not significantly affect the obstetrical and neonatal birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When neonatal birthweight is \u22653800\u2009g, maternal BMI at birth (<jats:italic>p<\/jats:italic>\u2009=\u20090.0283; aOR\u2009=\u20091.87 (1.19\u20133.97)) is independently associated with the rate of intrapartum cesarean delivery. However, pre\u2010pregnancy BMI and BMI\u2010gain during pregnancy were not associated with the need for intrapartum cesarean delivery or other adverse outcomes. Consequently, BMI at the time of birth could be more informative than pre\u2010pregnancy BMI and may improve counseling of women attempting vaginal breech birth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15002","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T10:25:53Z","timestamp":1731147953000},"page":"174-184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The interplay of body mass index, gestational weight gain, and birthweight over 3800\u2009g in vaginal breech birth: A retrospective study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5836-6761","authenticated-orcid":false,"given":"Henriette","family":"Tautenhahn","sequence":"first","affiliation":[{"name":"Department of Obstetrics University Hospital Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Dathan\u2010Stumpf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics University Hospital Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noura","family":"Kabbani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics University Hospital Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Stepan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics University Hospital Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-3792","authenticated-orcid":false,"given":"Massimiliano","family":"Lia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics University Hospital Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0202183"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.02.023"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108642"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12999"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801670"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13265"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.3635"},{"volume-title":"Weight Gain during Pregnancy: Reexamining the Guidelines","year":"2009","author":"Rasmussen KM","key":"e_1_2_13_9_1"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000815"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.3820"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(02)00092-9"},{"key":"e_1_2_13_14_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-067946","article-title":"Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta\u2010analysis","volume":"377","author":"Ye W","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_13_15_1","first-page":"2707","article-title":"Materno\u2010fetal and neonatal complications of diabetes in pregnancy: a retrospective study","volume":"9","author":"Capobianco G","year":"2020","journal-title":"Materno\u2010Fetal and Neonatal Complications of Diabetes in Pregnancy: A Retrospective Study J Clin Med"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14465"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12488"},{"key":"e_1_2_13_18_1","first-page":"70","volume-title":"Pr\u00e9sentation du si\u00e8ge. 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