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Mode of delivery and outcomes by birth weight among spontaneous and induced singleton cephalic nulliparous labors
Author(s) -
Walsh Jennifer M.,
Hehir Mark P.,
Robson Michael S.,
Mahony Rhona M.
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.10.029
Subject(s) - medicine , singleton , birth weight , obstetrics , cesarean delivery , observational study , gynecology , pregnancy , genetics , biology
Objective To assess the effect of birth weight on mode of delivery among nulliparous women in a setting with no policy of elective induction for suspected macrosomia. Methods In an observational study, data were assessed from nulliparous women with a single cephalic pregnancy of at least 37 weeks in spontaneous (Robson group 1) and induced (Robson group 2a) labor attending a hospital in Dublin, Ireland, between January 1, 2008, and December 31, 2009. The primary outcome measure was mode of delivery. Results A total of 7528 nulliparous labors were included (4989 in group 1 and 2539 in group 2a). The cesarean section rate was 15.1% overall (n = 1139), with 411 (8.2%) in group 1, and 728 (28.7%) in group 2a. Cesarean delivery rates rose with increasing birth weight in group 1, from 119 (6.3%) of 1886 infants weighing 3000–3499 g and 160 (8.5%) of 1892 weighing 3500–3999 g, to 19 (26.8%) of 71 weighing 4500–4999 g. Rates of cesarean delivery were significantly higher in induced labor (group 2a) for each birth‐weight category, ranging from 202 (25.9%) of 781 weighing 3000–3499 g and 243 (27.0%) of 899 weighing 3500–3999 g, to 38 (48.1%) of 79 weighing 4500–4999 g ( P < 0.01 for all). Conclusion In a setting with standardized management of labor, birth weight remains a significant determinant of mode of delivery.