Influence of advanced maternal age (≥35 years) on maternal and neonatal outcomes in vaginally intended breech deliveries at term-A FRABAT study.

OBJECTIVE

To examine maternal and neonatal outcomes in women aged 35 years and older compared with those under 35 years following planned vaginal breech deliveries.

METHODS

This study encompassed all vaginally intended breech deliveries at the Department of Obstetrics and Perinatal Medicine at Goethe University Hospital in Frankfurt from January 2004 to December 2023 (Frankfurt Breech at Term Cohort). Neonatal and maternal outcomes were compared by dividing the women into two groups and analyzing differences between groups using multivariate nominal regression adjusted for parity.

RESULTS

No difference in perinatal morbidity (measured with a modified PREMODA score) was observed for women with advanced age (35 years and older) (odds ratio [OR] 1.50, 95% confidence interval [CI] 0.74-3.02, P = 0.257) in vaginally intended deliveries. We found a significant association with advanced maternal age and cesarean section (OR 1.50, 95% CI 1.21-1.86, P < 0.001). Analysis of vaginally completed deliveries showed higher odds of postpartum hemorrhage (OR 1.50, 95% CI 1.19-5.25, P = 0.015). [Correction added on 20 December 2025 after first online publication: The preceding paragraph was corrected.]

CONCLUSION

Maternal age of 35 years or older is not linked to higher perinatal morbidity following vaginally attempted breech delivery. Nonetheless, a detailed consultation before delivery remains essential, particularly when pre-existing health conditions are present.

DEUTSCHES REGISTER KLINISCHER STUDIEN: DRKS00025030 (https://drks.de/search/de/trial/DRKS00025030/details).