Document Detail

The association between birthweight 4000 g or greater and perinatal outcomes in patients with and without gestational diabetes mellitus.
MedLine Citation:
PMID:  19376489     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of the study was to examine the association between birthweight of 4000 g or greater and perinatal outcomes in women with and without gestational diabetes mellitus (GDM). STUDY DESIGN: This was a retrospective cohort study of 36,241 singleton pregnancies stratified by the diagnosis of GDM, with presence or absence of birthweight of 4000 g or greater. Outcomes examined included neonatal hyperbilirubinemia, hypoglycemia, respiratory distress syndrome (RDS), shoulder dystocia, and Erb's palsy. chi(2) tests and multivariable logistic regression analyses were used to control for confounders. RESULTS: In women with GDM, neonates with a birthweight of 4000 g or greater, compared with those with a birthweight of less than 4000 g, had higher frequencies of hypoglycemia (5.3% vs 2.6%; P = .04), RDS (4.0% vs 1.5%; P = .03), shoulder dystocia (10.5% vs 1.6%; P < .001), and Erb's palsy (2.6% vs 0.2%; P < .001). Even without GDM, these outcomes occurred more frequently in infants with birthweight of 4000 g or greater. GDM increases the odds of adverse outcomes associated with birthweight of 4000 g or greater, particularly shoulder dystocia (adjusted odds ratios [aORs], 16.4 [GDM] vs 9.6 [non-GDM] and Erb's palsy (aORs, 41.9 [GDM] vs 6.7 [non-GDM]). CONCLUSION: Birthweight of 4000 g or greater is associated with a higher incidence of adverse perinatal outcomes such that neonatal providers should be alerted.
Tania F Esakoff; Yvonne W Cheng; Teresa N Sparks; Aaron B Caughey
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-18
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  200     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  672.e1-4     Citation Subset:  AIM; IM    
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, School of Medicine, San Francisco, CA, USA.
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MeSH Terms
Birth Weight*
Cohort Studies
Diabetes, Gestational*
Fetal Macrosomia / epidemiology*,  etiology*
Pregnancy Outcome
Retrospective Studies

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

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