Determinants of breech presentation at birth in sinletons at jimma university medical center, south west Ethiopia: a case-control study

Abstract

Background: Breech delivery is generally associated with higher perinatal morbidity and mortality and the optimal mode of delivery continues to be a source of debate. However, there is paucity of information about the factors associated with breech presentation at birth in singletons at the Jimma University medical center. Objective: To assess the determinants of breech presentation at birth in singletons in Jimma university medical center, south west Ethiopia from July, 2016 to July, 2017. Method: Hospital based case-control study was conducted in Jimma University medical center, labor ward from July, 2016 to July, 2017. Pre-tested structured questionnaires were used for data collection.Data was collected by Obstetrics and Gynecology residents in the labor ward; and entered into SPSS version 21 and descriptive statistic and binary logistic regression were used for analysis and result were expressed in narration from, tables and subsequent recommendations were forwarded based on the result. Result: Low birth weight, extremes of amniotic fluid volume (oligohyramnios, polyhydramnios), personal history of breech delivery and female fetus; were significantly associated with increased risk of breech presentations at birth in singletons .The associations of maternal age, parity, and previous history of Cesarean Section with breech presentations were not substantiated by this results. Uterine abnormalities; placental location, fetal congenital anomaly and maternal medical therapies; the overall incidence of these variables were significantly small to assess their impact on fetal presentations at birth in singletons. Conclusion and Recommendation: This study found low birth weight, extremes of amniotic fluid volume (oligohyramnios, polyhydramnios), History of breech delivery and Female gender were independent predictors of breech presentation at birth in singletons and recommended considering these significantly associated factors to anticipate breech presentation for further evaluation and management; in the study facility. Further prospective study is recommended on larger sample size over a longer study periods; to assess the associations of variables with few incidences; the variables which has no associations, to make the relative risks solid and the confidence intervals close into the risk factors and potential mechanisms of breech presentation.