Document Detail


Macrosomia: mode of delivery and pregnancy outcome.
MedLine Citation:
PMID:  20235897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess associations between birthweight and selected adverse outcomes in vaginal and cesarean deliveries and to clarify to which extent macrosomic births are delivered by cesarean section or are centralized to larger maternity units.
DESIGN: Cohort study.
SETTING: National study based on the Medical Birth Registry of Norway.
POPULATION: All births in Norway for the duration 1999-2005 comprising 304,968 vaginal and 47,702 cesarean deliveries.
METHODS: Rates of adverse pregnancy outcomes by birthweight in vaginal and cesarean deliveries were compared by odds ratios (ORs) obtained in logistic regression analysis with birthweight 2,500-3,999 g as the reference and adjusted for maternal age, birth order and size of maternity unit.
MAIN OUTCOME MEASURES: Analgesia, interventions, complications and neonatal outcomes.
RESULTS: For all the adverse outcomes, the ORs increased continuously from the reference group up to > or =5,000 g in which the highest adjusted ORs were observed for shoulder dystocia [64.2 (confidence interval 55.7-74.0)] and plexus injuries [47.7 (confidence interval 35.7-62.4)]. The proportion of adverse outcomes attributable to macrosomia (birthweight > or =4,500 g) ranged from 56.8% of all shoulder dystocia cases to 0.5% of all stillbirths. Macrosomic births were not centralized to larger maternity units and planned cesarean delivery was not more frequent in macrosomic births.
CONCLUSIONS: Macrosomic births involved excess risks of a series of adverse pregnancy outcomes, the births were not centralized to larger maternity units and planned cesarean section was not more frequent in macrosomic births.
Authors:
Astrid R Bjørstad; Kaja Irgens-Hansen; Anne Kjersti Daltveit; Lorentz M Irgens
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-28     Completed Date:  2010-05-12     Revised Date:  2011-05-19    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  664-9     Citation Subset:  IM    
Affiliation:
Locus for Registry Based Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, Bergen, Norway.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Apgar Score
Birth Weight
Cesarean Section / statistics & numerical data
Cohort Studies
Confidence Intervals
Delivery, Obstetric / methods*
Female
Fetal Macrosomia / ultrasonography*
Gestational Age
Humans
Infant Mortality / trends*
Infant, Newborn
Maternal Age
Middle Aged
Natural Childbirth / statistics & numerical data
Norway
Obstetric Labor Complications / diagnosis,  epidemiology
Odds Ratio
Parity
Pregnancy
Pregnancy Outcome*
Registries
Risk Assessment
Ultrasonography, Prenatal
Young Adult
Comments/Corrections
Comment In:
Acta Obstet Gynecol Scand. 2011 Feb;90(2):198; author reply 198-9   [PMID:  21241268 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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