Premium
Maternal and neonatal complications of fetal macrosomia: cohort study
Author(s) -
Beta J.,
Khan N.,
Fiolna M.,
Khalil A.,
Ramadan G.,
Akolekar R.
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.20278
Subject(s) - medicine , shoulder dystocia , fetal macrosomia , obstetrics , odds ratio , birth weight , brachial plexus injury , population , retrospective cohort study , pregnancy , brachial plexus , gestation , surgery , gestational diabetes , environmental health , biology , genetics
Objective To estimate the risks of maternal and neonatal complications in pregnancies with macrosomia. Methods This was a retrospective cohort study conducted at a large maternity unit in the UK between January 2009 and December 2016. The incidence of maternal and neonatal complications in pregnancies with macrosomia, defined as birth weight (BW) > 4000 g, and in those with severe macrosomia, defined as BW > 4500 g, was compared with that in pregnancies with normal BW (2500–4000 g). Regression analysis was performed to determine odds ratios (ORs) for complications in macrosomic pregnancies compared to those with normal BW. Results The study population of 35 548 pregnancies included 4522 (12.7%) with macrosomia, of which 643 (1.8%) had severe macrosomia, and 31 026 (87.3%) with normal BW. In the macrosomia group, the adjusted OR was 3.1 (95% CI, 2.6–3.6) for Cesarean section for failure to progress, 2.4 (95% CI, 2.0–3.0) for severe postpartum hemorrhage, 2.3 (95% CI, 1.9–2.8) for obstetric anal sphincter injury, 10.4 (95% CI, 8.6–12.6) for shoulder dystocia, 28.5 (95% CI, 8.9–90.7) for obstetric brachial plexus injury, 32.3 (95% CI, 3.8–278.2) for birth fractures and 4.4 (95% CI, 2.2–8.8) for hypoxic‐ischemic encephalopathy. The respective values in pregnancies with severe macrosomia were 4.3 (95% CI, 3.1–6.1), 2.9 (95% CI, 1.9–4.4), 3.1 (95% CI, 1.9–5.1), 28.7 (95% CI, 20.8–39.8), 73.9 (95% CI, 15.1–363.2), 87.2 (95% CI, 7.7–985.0) and 13.8 (95% CI, 5.2–36.8). Conclusion Macrosomia is associated with serious adverse perinatal outcomes. This study provides accurate estimates of risks to aid in pregnancy management. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.