PERINATAL OUTCOMES AND PREDICTORS OF MORTALITY IN SINGLETON BREECH DELIVERIES AT A NIGERIAN REFERRAL CENTER: A RETROSPECTIVE STUDY FROM SOUTHERN NIGERIA

ABSTRACT Breech presentation remains a major contributor to perinatal morbidity and mortality, particularly in low-resource settings. This study assessed perinatal outcomes and predictors of mortality in singleton breech deliveries at a tertiary referral hospital in southern Nigeria. A retrospective review of 209 singleton breech births from January 2008 to December 2012 was conducted using labour, theatre, and neonatal records. Data on maternal booking status, mode of delivery, birth weight, and Apgar scores were analyzed using descriptive and bivariate statistics (χ² and Fisher’s exact tests), with significance set at p < 0.05. The overall perinatal mortality rate was 301.4 per 1,000 births, significantly higher among unbooked mothers (544.3/1,000) than booked (153.9/1,000). Unbooked status strongly predicted intrauterine fetal death on admission (odds ratio = 7.35; 95% CI = 3.13–16.67). Low birth weight (<2.5 kg), Apgar score ≤ 6, and non-elective delivery modes were significantly associated with poor outcomes. Birth asphyxia was the leading cause of perinatal death. Strengthening antenatal care coverage, improving delivery preparedness, and ensuring skilled management of breech presentations are essential to reduce preventable perinatal deaths in similar settings.