Caesarean section is the safest form of delivery for breech babies, experts say today.
But the alternative carries only small risks, according to the study.
The analysis of 27 previous studies was carried out by Professor Yifru Berhan of Hawassa University College of Medicine and Health Sciences, Ethiopia, and colleagues.
Most breech babies in developed nations have been delivered by caesarean section over the last decade. But the risks of caesarean section must also be considered, they point out.
Information was taken from the previous studies on 258,953 pregnant women and their outcomes during delivery and up to a week afterwards. This showed that the overall risk of death for the baby was 0.3% for a planned vaginal delivery (about one in 300) and 0.05% for a planned caesarean (about one in 2,000).
Full details are published today (29 July) in BJOG: An International Journal of Obstetrics and Gynaecology.
"Our results show that the relative risk of perinatal mortality and morbidity was between two and five times higher in planned vaginal breech delivery compared to planned caesarean section birth," said Professor Berhan.
"However, the absolute risks were very small. Although the controversy is still unresolved, our study substantiates the practice of individualised decision making around delivering a breech baby. Future research should focus on a comparative study on vaginal breech and non-breech delivery."
Mervi Jokinen of the Royal College of Midwives commented: "Even combining all the studies does not necessarily give the right answers on an individual level. All births carry an element of risk, however small. The important issue here is that women are aware of the evidence around breech birth, so they can make a decision about how they want to give birth."
Berhan, Y. et al. The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: A meta-analysis including observational studies. BJOG 29 July 2015 doi: 10.1111/1471-0528.13524
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