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Obstetrics & Gynecology 2001;97:66-69
© 2001 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Osteogenesis Imperfecta: Mode of Delivery and Neonatal Outcome

RACHEL CUBERT, MD, EDITH Y. CHENG, MD, SARAH MACK, MELANIE G. PEPIN, MS and PETER H. BYERS, MD

From the Departments of Pathology, Obstetrics and Gynecology, and Medicine (Medical Genetics), University of Washington, Seattle, Washington.

Address reprint requests to: Edith Y. Cheng, MD Department of Obstetrics and Gynecology University of Washington Box 356460 1959 NE Pacific Street Seattle, WA 98195-6460 E-mail: chengels{at}u.washington.edu

Objective: To evaluate the pregnancy characteristics, methods of delivery, and neonatal outcomes of fetuses affected by osteogenesis imperfecta.

Methods: We reviewed medical records of 1016 individuals whose cells were sent to the University of Washington Collagen Diagnostic Laboratory between 1987 and 1994 for confirmation of diagnoses of osteogenesis imperfecta. Information and neonatal records were available for 167 of those pregnancies. From those we identified method(s) of prenatal detection, delivery method, and neonatal complications, including survival and acquisition of new fractures, and related them to type of delivery.

Results: The cesarean delivery rate was 54%, most of them (53%) for nonvertex presentation and fewer than 15% because of an antenatal diagnoses of osteogenesis imperfecta. There was an unusually high rate of breech presentation at term (37%). In infants with nonlethal forms of osteogenesis imperfecta, 24 of 59 (40%) delivered by cesarean and 17 of 53 (32%) delivered vaginally had new fractures ({chi}2 = .89; P = .3). Among 55 infants with the most severe form, 24 of 31 delivered by cesarean and 21 of 24 delivered vaginally died within 2 weeks of birth.

Conclusion: Cesarean delivery did not decrease fracture rates at birth in infants with nonlethal forms of osteogenesis imperfecta nor did it prolong survival for those with lethal forms. Prenatal diagnosis did not influence mode of delivery in most instances. Most cesarean deliveries were done for usual obstetric indications.






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