For babies in the breech position, cesarean delivery may be a safer choice than vaginal birth.
A Canadian study of 52,671 breech deliveries, published in Obstetrics & Gynecology, found that compared with C-sections, vaginal deliveries of breech babies were much more likely to result in an injured infant.
They also found that vaginal deliveries of breech babies had increased to 3.9 percent in 2011 from 2.7 percent in 2003.
About 88 percent of breech babies were delivered by planned C-section. Compared with those babies, breech babies delivered by C-section during labor had 2.79 times the rate of injury, and those delivered vaginally had 3.6 times the rate.
Some breech babies should not be delivered vaginally in any case, according to the lead author, Dr. Janet Lyons, an assistant professor at the University of British Columbia.
Those who are not full term, or with feet first instead of buttocks first, or those with birth anomalies like hydrocephalus, are not good candidates. But, she added, some women want vaginal delivery of a breech baby.
“The role of the provider,” she said, “is to decide who is suited to a vaginal breech and who is not, and to make sure the woman has all the information to make a good decision.”
Here’s another reason to get a measles shot: Vaccination not only protects against measles, but reduces childhood deaths from other infections, a new study has found.
Researchers examined data on post-measles infections in the United States, England, Wales and Denmark before and after the measles vaccine became available in the 1960s.
They found a correlation between the number of measles cases in a given period and the number of deaths from non-measles infectious diseases in children in the two to three years afterward.
The findings were published in Science.
“With mathematical analysis of all of the epidemiological evidence we have,” said the lead author, Michael J. Mina, who was a postdoctoral student at Princeton when the study was done, “it seems that when measles was prevalent, it would go through a population, and that population would be at increased risk for mortality from other diseases for about 28 months, and in proportion to how many people were infected with measles.”
That measles depresses the immune response has been known for some time. Animal studies suggest that measles infection depletes B and T lymphocytes, specialized white blood cells that produce antibodies that “remember” the measles virus, providing immunity against further attacks.
The immune system then recovers, but for many months after, the cells that repopulate the system are almost all effective only against the measles virus. You will never get measles again, but you are temporarily left susceptible to other diseases.
“The immune system is working fine,” Mina explained. “But the assortment of stuff it protects against is decreased.”
The measles vaccine provides immunity, too, but in a way different from measles infection. The attenuated live vaccine does not reduce the number of B and T lymphocytes, so their ability to fight other diseases is preserved.
The researchers calculate that when measles was common, it was a contributor to as many as half of all childhood deaths from infectious diseases in industrialized countries.
In industrialized countries, the vaccine prevents mainly deaths from respiratory infections; in poor countries, the vaccine primarily reduces deaths from diarrheal diseases and dysentery.
New York Times News Service