Objective: To re-examine the risk factors for shoulder dystocia given the increasing rates of obesity and diabetes in pregnant women.
Design: Retrospective observational study.
Setting: Five hospitals located in Wisconsin, Florida, Maryland, Michigan, and Alabama.
Participants: We evaluated 19,236 births that occurred between April 1, 2011, and July 25, 2013.
Methods: Data were collected from electronic medical records and used to evaluate the risk of shoulder dystocia. Data were analyzed using a generalized linear mixed model, which controlled for clustering due to site.
Results: When insulin was prescribed, gestational diabetes was associated with an increased risk of shoulder dystocia (odds ratio = 2.10, 95% confidence interval [1.01, 4.37]); however, no similar association was found with regard to gestational diabetes treated with glycemic agents or through diet. Use of epidural anesthesia was associated with an increased risk for shoulder dystocia (odds ratio = 3.47, 95% confidence interval [2.72, 4.42]). Being Black or Hispanic, being covered by Medicaid or having no insurance, infant gestational age of 41 weeks or greater, and chronic diabetes were other significant risk factors.
Conclusion: With the changing characteristics of pregnant women, labor and birth clinicians care for more pregnant women who have an increased risk for shoulder dystocia. Our findings may help prospectively identify women with the greatest risk.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jogn.2017.11.011 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hybrid remote and in-clinic maternal-fetal surveillance for women with gestational diabetes: A prospective pilot study.
Int J Gynaecol Obstet
January 2025
The Josef Buchmann Gynecology and Maternity Center, Sheba Medical Center, Tel Hashomer, Israel.
Objective: This study explores a hybrid approach to maternal-fetal care for gestational diabetes (GD), integrating virtual visits seamlessly with in-clinic assessments. We assessed the feasibility, time efficiency, patient satisfaction, and clinical outcomes to facilitate wider adoption of maternal-fetal telemedicine.
Methods: We conducted a 4-week prospective study involving 20 women with GD at ≥32 weeks of pregnancy, alternating between remote and in-clinic weekly visits.
Experimental Biomechanics of Neonatal Brachial Plexus Avulsion Injuries Using a Piglet Model.
Bioengineering (Basel)
January 2025
School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA.
Background: A brachial plexus avulsion occurs when the nerve root separates from the spinal cord during birthing trauma, such as shoulder dystocia or a difficult vaginal delivery. A complete paralysis of the affected levels occurs post-brachial plexus avulsion. Despite being reported in 10-20% of brachial plexus birthing injuries, it remains poorly diagnosed during the acute stages of injury, leading to poor intervention approaches.
View Article and Find Full Text PDFGestational Diabetes Mellitus: Mechanisms Underlying Maternal and Fetal Complications.
Endocrinol Metab (Seoul)
January 2025
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Gestational diabetes mellitus (GDM) affects over 10% of all pregnancies, both in Korea and worldwide. GDM not only increases the risk of adverse pregnancy outcomes such as preeclampsia, preterm birth, macrosomia, neonatal hypoglycemia, and shoulder dystocia, but it also significantly increases the risk of developing postpartum type 2 diabetes mellitus and cardiovascular disease in the mother. Additionally, GDM is linked to a higher risk of childhood obesity and diabetes in offspring, as well as neurodevelopmental disorders, including autistic spectrum disorder.
View Article and Find Full Text PDFToo Much of a Good Thing: Updated Current Management and Perinatal Outcomes of Polyhydramnios.
J Med Ultrasound
November 2024
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Amniotic fluid assessment is crucial in prenatal ultrasound to monitor fetal conditions, with polyhydramnios, characterized by excessive amniotic fluid, affecting 1%-2% of pregnancies. Polyhydramnios is linked to complications such as placental abruption, preterm labor, congenital anomalies, and postpartum hemorrhage, emphasizing the need for early detection and management. While idiopathic causes account for 60%-70% of cases, other causes include impaired fetal swallowing and increased urine production due to maternal, fetal, and placental conditions.
View Article and Find Full Text PDFEpidemiology of Macrosomia in Saudi Arabia: An Analysis of 12,045 Pregnancies from the Riyadh Mother and Baby Multicenter Cohort Study (RAHMA) Database.
Healthcare (Basel)
December 2024
Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh 11451, Saudi Arabia.
Objective: To investigate the prevalence, risk factors, and complications associated with delivering macrosomic babies.
Methods: Singleton term pregnancies (12,045) were studied. Macrosomia was categorized using the following two definitions: birthweight > 4 kg and birthweight ≥ 90th percentile (3.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!