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Maternal and neonatal outcomes of large for gestational age pregnancies.
MedLine Citation:
PMID:  22471810     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To compare maternal and neonatal outcomes of term large-for-gestational age (LGA) pregnancies and adequate-for-gestational age (AGA) pregnancies. Design. Retrospective analysis. Setting. Large university research medical center. Population. All term singleton LGA (birthweight ≥90(th) percentile) and AGA pregnancies (birthweight 10.1-89.9(th) percentile) delivering between 2004 and 2008. Methods. Data collected included maternal age, gestational age at delivery, mode of delivery, birthweight, fetal gender, maternal and neonatal complications. Birthweight percentiles were determined according to locally-derived gender-specific birthweight tables. Main outcome measures. Comparisons between LGA and AGA pregnancies and between LGA 90-94.9(th) percentile, 95-98.9(th) percentile and ≥99(th) percentile. Results. The study population comprised 34 685 pregnancies; 3900 neonates matched the definition of term LGA. Maternal age and gestational age at delivery were significantly higher for LGA neonates. Significantly more LGA neonates were born by cesarean section, and significantly more LGA pregnancies were complicated by postpartum hemorrhage (PPH), shoulder dystocia, neonatal hypoglycemia, and had a longer hospitalization period. Maternal and neonatal risks increased as birthweight increased from the 90-94.9(th) percentile to 95-98.9(th) percentile to ≥99(th) percentile. Specifically, the risks of shoulder dystocia (odds ratio (OR) 2.61, 3.35, 5.11, respectively), PPH (OR 1.81, 2.12, 3.92, respectively), and neonatal hypoglycemia (OR 2.53, 3.8 and 5.19, respectively) all linearly increased with birthweight percentile. Conclusions. LGA is associated with increased rate of cesarean section, PPH, shoulder dystocia, neonatal hypoglycemia, and longer hospitalization. These risks increase as the birth percentile rises. These risks need to be emphasized in pre-delivery counseling.
Authors:
Alina Weissmann-Brenner; Michal J Simchen; Eran Zilberberg; Anat Kalter; Boaz Weisz; Reuven Achiron; Mordechai Dulitzky
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-4
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel HaShomer, Israel.
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