Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Norway. martha.eide@mfr.uib.no
OBJECTIVE: Long-term intellectual performance in breech-presented infants may be negatively affected by vaginal delivery. We evaluated the effect of presentation at birth and delivery mode on intellectual performance at age 18 years in a nationwide population study. METHODS: We studied 8,738 male infants in breech and 384,832 males in cephalic presentation registered in the Medical Birth Registry of Norway, 1967-1979, and linked to data registered at the National Conscript Service, 1984-1999. Test scores of intelligence testing at conscription were presented as standard nine ("stanine") scores. Mean stanine scores and odds ratios of low score were computed and adjusted for birth order, maternal age, and education. RESULTS: Mean stanine score was slightly higher among breech-presented males than among cephalic-presented males (5.26 versus 5.22, P = .05), whereas after adjustment the difference disappeared (P = .3). Breech-presented infants had lower mean scores if delivered by cesarean compared with vaginal breech delivery (P = .03), and cephalic-presented males scored lower if their mothers had a cesarean delivery instead of a vaginal delivery (P