Medline ® Abstract for Reference 11
of 'Shoulder dystocia: Risk factors and planning delivery of at risk pregnancies'
11
TI
Obstetric and neonatal risks among extremely macrosomic babies and their mothers.
AU
Vidarsdottir H, Geirsson RT, Hardardottir H, Valdimarsdottir U, Dagbjartsson A
SO
Am J Obstet Gynecol. 2011;204(5):423.e1.
OBJECTIVE:
We estimated the risk of complications at birth of extremely large babies (≥5000 g).
STUDY DESIGN:
This was a cohort study including all births of extremely large babies in 1996 through 2005 and comparison cohort with normal birthweight (1:2) identified in the national birth registration.
RESULTS:
There were 343 extremely large babies or 0.9% of all singletons. Compared to the normal birthweight cohort (n = 679), there were increased odds of shoulder dystocia (odds ratio [OR], 26.9; 95% confidence interval [CI], 11.1-65.1), emergency cesarean section (OR, 5.2; 95% CI, 3.4-8.0), and failed labor induction (OR, 4.3; 95% CI, 1.7-11.0). The risk of elective section was not increased (OR, 1.1; 95% CI, 0.6-2.0). Minor congenital malformations were more frequent (OR, 2.1; 95% CI, 1.2-3.7), as were birth injuries (OR, 3.7; 95% CI, 2.1-6.8) and minor metabolic disturbance (OR, 2.5; 95% CI, 1.1-6.2), but not asphyxial births.
CONCLUSION:
The risk of shoulder dystocia for very large babies is markedly raised, as are minor complications, while for mothers the main risk is emergency section.
AD
Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
PMID