Jennifer R King1, Lisa M Korst, David A Miller, Joseph G Ouzounian. 1. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Abstract
OBJECTIVE: To determine the composite risk of maternal and neonatal morbidity in pregnancies with suspected fetal macrosomia. METHODS: In a retrospective study of laboring women delivering singleton, term neonates, we defined 3 groups of patients by estimated fetal weight (EFW) in grams, using ultrasound: (1) <4000, (2) 4000-4499, and (3) 4500+, and tested them for association with a composite outcome using multivariable logistic regression models. The measure of composite morbidity included: shoulder dystocia, third/fourth degree perineal laceration, postpartum hemorrhage, maternal length of stay (LOS) ≥ 5 days, neonatal birth trauma, meconium aspiration syndrome, perinatal infection, and neonatal LOS ≥ 5 days. Because of potential interactions between diabetes and birthweight, women with maternal diabetes were examined separately. RESULTS: Of 8,843 deliveries, the proportion with composite morbidity by group was: (1): 26.2%, (2): 41.2%, and (3): 63.6% (p < 0.0001). The OR (95% CI) for groups (2) and (3) were: 1.9 (1.2-2.9) and 2.1 (0.6-7.2), for diabetics (9.7% of the final study population), and 2.3 (1.9-2.7) and 3.9 (2.2-6.9), for non-diabetics. CONCLUSIONS: Suspected fetal macrosomia appeared associated with increased risk for a composite measure of childbirth morbidity.
OBJECTIVE: To determine the composite risk of maternal and neonatal morbidity in pregnancies with suspected fetal macrosomia. METHODS: In a retrospective study of laboring women delivering singleton, term neonates, we defined 3 groups of patients by estimated fetal weight (EFW) in grams, using ultrasound: (1) <4000, (2) 4000-4499, and (3) 4500+, and tested them for association with a composite outcome using multivariable logistic regression models. The measure of composite morbidity included: shoulder dystocia, third/fourth degree perineal laceration, postpartum hemorrhage, maternal length of stay (LOS) ≥ 5 days, neonatal birth trauma, meconium aspiration syndrome, perinatal infection, and neonatal LOS ≥ 5 days. Because of potential interactions between diabetes and birthweight, women with maternal diabetes were examined separately. RESULTS: Of 8,843 deliveries, the proportion with composite morbidity by group was: (1): 26.2%, (2): 41.2%, and (3): 63.6% (p < 0.0001). The OR (95% CI) for groups (2) and (3) were: 1.9 (1.2-2.9) and 2.1 (0.6-7.2), for diabetics (9.7% of the final study population), and 2.3 (1.9-2.7) and 3.9 (2.2-6.9), for non-diabetics. CONCLUSIONS: Suspected fetal macrosomia appeared associated with increased risk for a composite measure of childbirth morbidity.
Authors: Sarah J Pugh; Paul S Albert; Sungduk Kim; William Grobman; Stefanie N Hinkle; Roger B Newman; Deborah A Wing; Katherine L Grantz Journal: Am J Obstet Gynecol Date: 2017-05-11 Impact factor: 8.661
Authors: Katherine L Grantz; Sungduk Kim; William A Grobman; Roger Newman; John Owen; Daniel Skupski; Jagteshwar Grewal; Edward K Chien; Deborah A Wing; Ronald J Wapner; Angela C Ranzini; Michael P Nageotte; Stefanie N Hinkle; Sarah Pugh; Hanyun Li; Karin Fuchs; Mary Hediger; Germaine M Buck Louis; Paul S Albert Journal: Am J Obstet Gynecol Date: 2018-05-24 Impact factor: 8.661
Authors: Samrawit F Yisahak; Stefanie N Hinkle; Sunni L Mumford; Mengying Li; Victoria C Andriessen; Katherine L Grantz; Cuilin Zhang; Jagteshwar Grewal Journal: Int J Epidemiol Date: 2021-03-03 Impact factor: 7.196