Maternal and paternal contribution to intergenerational recurrence of breech delivery: population based cohort study

doi:10.1136/bmj.39505.436539.BE

BMJ 2008;336:872-876 (19 April), doi:10.1136/bmj.39505.436539.BE (published 27 March 2008)

Research

Maternal and paternal contribution to intergenerational recurrence of breech delivery: population based cohort study

Tone Irene Nordtveit, PhD student¹, Kari Klungsoyr Melve, associate professor¹^,2, Susanne Albrechtsen, obstetrician³, Rolv Skjaerven, professor¹^,2

¹ Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Postbox 7804, N-5020 Bergen, Norway, ² Medical Birth Registry, Norwegian Institute of Public Health, Norway, ³ Department of Obstetrics and Gynaecology, Haukeland University Hospital, N-5021 Bergen, Norway

Correspondence to: Tone Irene Nordtveit Tone.Nordtveit{at}isf.uib.no

Objective To investigate intergenerational recurrence of breechdelivery, with a hypothesis that both women and men deliveredin breech presentation contribute to increased risk of breechdelivery in their offspring.

Design Population based cohort study for two generations.

Setting Data from the medical birth registry of Norway, basedon all births in Norway 1967-2004 (2.2 million births).

Participants Generational data were provided through linkageby national identification numbers, forming 451 393 mother-offspringunits and 295 253 father-offspring units. We included unitswhere both parents and offspring were singletons and offspringwere first born, forming 232 704 mother-offspring units and154 851 father-offspring units for our analyses.

Main outcome measure Breech delivery in the second generation.

Results Men and women who themselves were delivered in breechpresentation had more than twice the risk of breech deliveryin their own first pregnancies compared with men and women whohad been cephalic presentations (odds ratios 2.2, 95% confidenceinterval 1.8 to 2.7, and 2.2, 1.9 to 2.5, for men and women,respectively). The strongest risks of recurrence were foundfor vaginally delivered offspring and were equally strong formen and women. Increased risk of recurrence of breech deliveryin offspring was present only for parents delivered at term.

Conclusion Intergenerational recurrence risk of breech deliveryin offspring was equally high when transmitted through fathersand mothers. It seems reasonable to attribute the observed patternof familial predisposition to term breech delivery to geneticinheritance, predominantly through the fetus.

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