Differences between breech and cephalic neonates born after planned cesarean section: a systematic review

Yi Du; Xiaoyun Zhang; Xinyu Zhou; Philip N. Baker; Mark D. Kilby; Chao Tong

doi:10.1186/s12884-025-08327-z

Differences between breech and cephalic neonates born after planned cesarean section: a systematic review

Yi Du
, Xiaoyun Zhang
, Xinyu Zhou
, Philip N. Baker
, Mark D. Kilby
, Chao Tong^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: A growing number of studies have found that breech presentation is related to preexisting diseases and may affect future fetal development. This study aimed to compare the differences between breech presentation and cephalic presentation and explore the underlying mechanisms of adverse outcomes caused by fetal station itself.

Methods: ‘PubMed’, ‘Embase’ and ‘Cochrane Library’ were searched from inception to October 21, 2022. Comparative studies containing ‘prelabor CS’ or ‘elective CS’ of cephalic and breech presentation were included. A total of 585 studies were included, and 5 studies were eligible for final research. Review Manager 5.4.1 was used for data synthesis.

Results: The mortality of breech group is not different from that of cephalic group (RR 0.69, 95% CI 0.09–5.13, p = 0.71). No differences in infant (< 1 year) and neonatal (0–27 days) mortality were found between the breech and cephalic presentations (RR 1.56, 95% CI 0.86–2.82, p = 0.14). However, breech group was found to have lower birth weight (p < 0.002), umbilical coiling index(p < 0.0001), and bone SOS (p = 0.03 )than cephalic group.

Conclusions: The breech presentation itself may not be related to adverse pregnancy outcomes, and more attention is needed for further exploration.

Original language	English
Article number	1170
Number of pages	8
Journal	BMC pregnancy and childbirth
Volume	25
Early online date	7 Nov 2025
DOIs	https://doi.org/10.1186/s12884-025-08327-z
Publication status	E-pub ahead of print - 7 Nov 2025

Keywords

Autoregulation
Cerebral circulation
Apgar score
Light perception
Neurological development
Morbidity
Mortality
External cephalic version
Neonates
Fetus

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title = "Differences between breech and cephalic neonates born after planned cesarean section: a systematic review",

abstract = "Background: A growing number of studies have found that breech presentation is related to preexisting diseases and may affect future fetal development. This study aimed to compare the differences between breech presentation and cephalic presentation and explore the underlying mechanisms of adverse outcomes caused by fetal station itself. Methods: {\textquoteleft}PubMed{\textquoteright}, {\textquoteleft}Embase{\textquoteright} and {\textquoteleft}Cochrane Library{\textquoteright} were searched from inception to October 21, 2022. Comparative studies containing {\textquoteleft}prelabor CS{\textquoteright} or {\textquoteleft}elective CS{\textquoteright} of cephalic and breech presentation were included. A total of 585 studies were included, and 5 studies were eligible for final research. Review Manager 5.4.1 was used for data synthesis. Results: The mortality of breech group is not different from that of cephalic group (RR 0.69, 95\% CI 0.09–5.13, p = 0.71). No differences in infant (< 1 year) and neonatal (0–27 days) mortality were found between the breech and cephalic presentations (RR 1.56, 95\% CI 0.86–2.82, p = 0.14). However, breech group was found to have lower birth weight (p < 0.002), umbilical coiling index(p < 0.0001), and bone SOS (p = 0.03 )than cephalic group. Conclusions: The breech presentation itself may not be related to adverse pregnancy outcomes, and more attention is needed for further exploration. ",

keywords = "Autoregulation, Cerebral circulation, Apgar score, Light perception, Neurological development, Morbidity, Mortality, External cephalic version, Neonates, Fetus",

author = "Yi Du and Xiaoyun Zhang and Xinyu Zhou and Baker, \{Philip N.\} and Kilby, \{Mark D.\} and Chao Tong",

year = "2025",

month = nov,

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doi = "10.1186/s12884-025-08327-z",

language = "English",

volume = "25",

journal = "BMC pregnancy and childbirth",

issn = "1471-2393",

publisher = "Springer",

}

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T1 - Differences between breech and cephalic neonates born after planned cesarean section

T2 - a systematic review

AU - Du, Yi

AU - Zhang, Xiaoyun

AU - Zhou, Xinyu

AU - Baker, Philip N.

AU - Kilby, Mark D.

AU - Tong, Chao

PY - 2025/11/7

Y1 - 2025/11/7

N2 - Background: A growing number of studies have found that breech presentation is related to preexisting diseases and may affect future fetal development. This study aimed to compare the differences between breech presentation and cephalic presentation and explore the underlying mechanisms of adverse outcomes caused by fetal station itself. Methods: ‘PubMed’, ‘Embase’ and ‘Cochrane Library’ were searched from inception to October 21, 2022. Comparative studies containing ‘prelabor CS’ or ‘elective CS’ of cephalic and breech presentation were included. A total of 585 studies were included, and 5 studies were eligible for final research. Review Manager 5.4.1 was used for data synthesis. Results: The mortality of breech group is not different from that of cephalic group (RR 0.69, 95% CI 0.09–5.13, p = 0.71). No differences in infant (< 1 year) and neonatal (0–27 days) mortality were found between the breech and cephalic presentations (RR 1.56, 95% CI 0.86–2.82, p = 0.14). However, breech group was found to have lower birth weight (p < 0.002), umbilical coiling index(p < 0.0001), and bone SOS (p = 0.03 )than cephalic group. Conclusions: The breech presentation itself may not be related to adverse pregnancy outcomes, and more attention is needed for further exploration.

AB - Background: A growing number of studies have found that breech presentation is related to preexisting diseases and may affect future fetal development. This study aimed to compare the differences between breech presentation and cephalic presentation and explore the underlying mechanisms of adverse outcomes caused by fetal station itself. Methods: ‘PubMed’, ‘Embase’ and ‘Cochrane Library’ were searched from inception to October 21, 2022. Comparative studies containing ‘prelabor CS’ or ‘elective CS’ of cephalic and breech presentation were included. A total of 585 studies were included, and 5 studies were eligible for final research. Review Manager 5.4.1 was used for data synthesis. Results: The mortality of breech group is not different from that of cephalic group (RR 0.69, 95% CI 0.09–5.13, p = 0.71). No differences in infant (< 1 year) and neonatal (0–27 days) mortality were found between the breech and cephalic presentations (RR 1.56, 95% CI 0.86–2.82, p = 0.14). However, breech group was found to have lower birth weight (p < 0.002), umbilical coiling index(p < 0.0001), and bone SOS (p = 0.03 )than cephalic group. Conclusions: The breech presentation itself may not be related to adverse pregnancy outcomes, and more attention is needed for further exploration.

KW - Autoregulation

KW - Cerebral circulation

KW - Apgar score

KW - Light perception

KW - Neurological development

KW - Morbidity

KW - Mortality

KW - External cephalic version

KW - Neonates

KW - Fetus

U2 - 10.1186/s12884-025-08327-z

DO - 10.1186/s12884-025-08327-z

M3 - Article

SN - 1471-2393

VL - 25

JO - BMC pregnancy and childbirth

JF - BMC pregnancy and childbirth

M1 - 1170

ER -

Differences between breech and cephalic neonates born after planned cesarean section: a systematic review

Abstract

Keywords

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