Last Updated: 2003-06-05 1:00:08 -0400 (Reuters Health)

LONDON (Reuters Health) - Planned caesarean section may be best for breech babies but this should be weighed against the significant risk to the mother, Dutch researchers said on Thursday.

The team compared the outcome of 33,824 infants born in the breech position in Holland from 1995 to 1999 according to whether they were delivered by planned caesarean section, emergency caesarean or vaginal delivery.

The findings, published in the British Journal of Obstetrics and Gynaecology, show that vaginal delivery and emergency caesarean section resulted in a sevenfold increase in low Apgar score -- a measure of newborn health that takes into account heart rate, respiration and other factors -- a threefold increase in birth trauma and a twofold increase in infant deaths compared with planned caesarean section.

Dr. Christine C.Th. Rietberg of Vlietland Hospital in Vlaardingen and colleagues note that the findings confirm the results of a previous study that was published in the journal The Lancet in October 2000.

But they warn that the benefits to the infants should be weighed against the results of other studies showing that caesarean section is associated with two to 11 times the risk of maternal death.

They add: "Maternal morbidity associated with caesarean section might be up to five to 10 times that of vaginal birth, most commonly manifest by infection, followed by blood transfusion."

The researchers also point out that "infection is less likely following planned surgery than after an emergency ... caesarean section but is still significantly higher than after vaginal birth.