Customized and non-customized live-born birth-weight curves of single and uncomplicated pregnancies from the Burgundy perinatal network. Part I - methodology.

OBJECTIVES: To establish non-customized and customized birth-weight curves of single and uncomplicated pregnancies according to gestational age. MATERIALS AND METHODS: We used data for 64,173 mother-infants pairs from the Burgundy perinatal network database (France) over the period 2005-2013. A validated procedure was used to link mothers with their newborns, and maternal and fetal pathologies likely to affect birth weight were excluded. Multiple regression analysis with covariate selection was used to build a customized growth curve with maternal and fetal parameters. RESULTS: Using this methodology, three different curves were generated: an unadjusted curve for birth weight, named B0, an curve adjusted for fetal gender, named B1 and a curve adjusted for fetal and maternal parameters (fetal gender, maternal height, weight and parity), named B2. CONCLUSION: We present curves showing an original distribution of birth weights for the French population in order to improve the diagnosis of small for gestational age. These curves are not based on the Gardosi in utero growth model but on actual birth weights, thus limiting bias. Nevertheless, the minimum gestational age was 25weeks as there was an insufficient number of live-borns in small gestational ages.

Induced labour at term and breech presentation: Experience of a level IIB French maternity.

Data from the literature on induction of labour in breech presentation are rare and no conclusions can be drawn for this procedure. OBJECTIVES: To evaluate obstetrical and neonatal prognosis following induced labour in breech deliveries at term (37 to 42 weeks of gestation). METHODS: We conducted a single-centre retrospective case-control study in a level IIB maternity unit from 1st January 2012 to 31st December 2015. The inclusion criteria were a singleton pregnancy and a breech presentation. RESULTS: A total of 235 patients were included, 178 in the spontaneous labour group (group A), 57 in the induced labour group (whatever the procedure used: oxytocin or prostaglandin) (group B). There was no significant difference concerning the vaginal delivery rate between group A and group B (88.2% versus 91.2%). Both groups were also similar for transfers to neonatal units (10.7% versus 15.8%), pH<7.0 (1.1% versus 1.8%) and 5-minute Apgar<4 (1.1% versus 1.7%). There were no neonatal deaths or transfers to neonatal intensive care units. CONCLUSION: Induced labour in breech presentation is feasible with a vaginal delivery rate similar to that in spontaneous labour and the same neonatal outcomes. This therapeutic option must be considered in trained obstetrical teams when vaginal delivery in breech presentations is not contraindicated.