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Am J Perinatol 2021; 38(02): 150-157
DOI: 10.1055/s-0039-1695013
Original Article

Macrosomic Newborns Delivered at Term after Labor among Nondiabetic Women: Maternal and Neonatal Morbidities

Han-Yang Chen
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
,
Suneet P. Chauhan
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas
› Author Affiliations Funding None.
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Abstract

Objective This study aimed to compare morbidities among nonmacrosomic versus macrosomic singleton live births of nondiabetic women who labored.

Study Design This retrospective study utilized the 2003 revision of U.S. birth certificate data of singleton live births (2011–2013) at 37 to 41 weeks who labored. The primary outcomes were composite maternal and neonatal morbidities (CMM and CNM, respectively). We compared these outcomes by birth weight, 2,500 to 3,999 g (group 1; reference), 4,000 to 4,449 g (group 2), and 4,500 to 5,999 g (group 3). We used multivariable Poisson regression analyses to examine the association between birth weight groups and the outcomes.

Results Among 6,691,338 live births, 92.0% were in group 1, 7.1% in group 2, and 0.9% in group 3. The overall CMM and CNM rates were 4.4 and 6.8 per 1,000 live births, respectively. Compared with group 1, the risk of CMM was significantly higher in group 2 (adjusted risk ratio [aRR] = 1.50; 95% confidence interval [CI]: 1.44–1.56) and group 3 (aRR = 2.00; 95% CI: 1.82–2.19). Likewise, the risk of CNM was significantly higher in group 2 (aRR = 1.38; 95% CI: 1.33–1.43) and group 3 (aRR = 2.57; 95% CI: 2.40–2.75) than in group 1.

Conclusion Nondiabetic women who labor with a macrosomic newborns have a significantly higher rate of adverse outcomes than nonmacrosomic.

Keywords

macrosomia - maternal morbidity - neonatal morbidity - nondiabetics


Publication History

Received: 09 May 2019

Accepted: 11 July 2019

Article published online:
20 August 2019

© 2019. Thieme. All rights reserved.

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  • References

  • 1 American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics; Barth Jr WH. Practice bulletin no. 173: fetal macrosomia. Obstet Gynecol 2016; 128 (05) e195-e209
    CrossrefPubMedGoogle Scholar
  • 2 Hamilton BE, Martin JA, Osterman MJK, Curtin SC, Matthews TJ. Births: final data for 2014. National vital statistics reports. Natl Vital Stat Rep 2015; 64 (12) 1-64
    PubMedGoogle Scholar
  • 3 Stotland NE, Caughey AB, Breed EM, Escobar GJ. Risk factors and obstetric complications associated with macrosomia. Int J Gynaecol Obstet 2004; 87 (03) 220-226
    CrossrefPubMedGoogle Scholar
  • 4 King JR, Korst LM, Miller DA, Ouzounian JG. Increased composite maternal and neonatal morbidity associated with ultrasonographically suspected fetal macrosomia. J Matern Fetal Neonatal Med 2012; 25 (10) 1953-1959
    CrossrefPubMedGoogle Scholar
  • 5 Bukowski R, Hansen NI, Willinger M. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Stillbirth Collaborative Research Network. Fetal growth and risk of stillbirth: a population-based case-control study. PLoS Med 2014; 11 (04) e1001633
    CrossrefPubMedGoogle Scholar
  • 6 Chiossi G, Pedroza C, Costantine MM, Truong VTT, Gargano G, Saade GR. Customized vs population-based growth charts to identify neonates at risk of adverse outcome: systematic review and Bayesian meta-analysis of observational studies. Ultrasound Obstet Gynecol 2017; 50 (02) 156-166
    CrossrefPubMedGoogle Scholar
  • 7 Larkin JC, Speer PD, Simhan HN. A customized standard of large size for gestational age to predict intrapartum morbidity. Am J Obstet Gynecol 2011; 204 (06) 499.e1-499.e10
    CrossrefPubMedGoogle Scholar
  • 8 Froehlich R, Simhan HN, Larkin JC. An evidence-based approach to defining fetal macrosomia. Am J Perinatol 2016; 33 (05) 456-462
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Zhang X, Decker A, Platt RW, Kramer MS. How big is too big? The perinatal consequences of fetal macrosomia. Am J Obstet Gynecol 2008; 198 (05) 517.e1-517.e6
    CrossrefPubMedGoogle Scholar
  • 10 Ecker JL, Greenberg JA, Norwitz ER, Nadel AS, Repke JT. Birth weight as a predictor of brachial plexus injury. Obstet Gynecol 1997; 89 (5, Pt. 1): 643-647
    CrossrefPubMedGoogle Scholar
  • 11 Boulet SL, Alexander GR, Salihu HM, Pass M. Macrosomic births in the united states: determinants, outcomes, and proposed grades of risk. Am J Obstet Gynecol 2003; 188 (05) 1372-1378
    CrossrefPubMedGoogle Scholar
  • 12 Jenner ZB, O'Neil Dudley AE, Mendez-Figueroa H, Ellis VS, Chen HY, Chauhan SP. Morbidity associated with fetal macrosomia among women with diabetes mellitus. Am J Perinatol 2018; 35 (05) 515-520
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Palatnik A, Grobman WA, Hellendag MG, Janetos TM, Gossett DR, Miller ES. Predictors of shoulder dystocia at the time of operative vaginal delivery. Am J Obstet Gynecol 2016; 215 (05) 624.e1-624.e5
    CrossrefPubMedGoogle Scholar
  • 14 ACOG practice bulletin no. 201: pregestational diabetes mellitus. Obstet Gynecol 2018; 132 (06) e228-e248
    CrossrefPubMedGoogle Scholar
  • 15 Committee on Practice Bulletins—Obstetrics; Caughey AB, Turrentine M. ACOG practice bulletin no. 190: gestational diabetes mellitus. Obstet Gynecol 2018; 131 (02) e49-e64
    CrossrefPubMedGoogle Scholar
  • 16 Hammad IA, Chauhan SP, Magann EF, Abuhamad AZ. Peripartum complications with cesarean delivery: a review of Maternal-Fetal Medicine Units Network publications. J Matern Fetal Neonatal Med 2014; 27 (05) 463-474
    CrossrefPubMedGoogle Scholar
  • 17 Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol 1996; 87 (02) 163-168
    CrossrefPubMedGoogle Scholar
  • 18 Osterman MJ, Martin JA, Mathews TJ, Hamilton BE. Expanded data from the new birth certificate, 2008. Natl Vital Stat Rep 2011; 59 (07) 1-28
    PubMedGoogle Scholar
  • 19 Boulvain M, Senat MV, Perrotin F. et al; Groupe de Recherche en Obstétrique et Gynécologie (GROG). Induction of labour versus expectant management for large-for-date fetuses: a randomised controlled trial. Lancet 2015; 385 (9987): 2600-2605
    CrossrefPubMedGoogle Scholar
  • 20 Heywood RE, Magann EF, Rich DL, Chauhan SP. The detection of macrosomia at a teaching hospital. Am J Perinatol 2009; 26 (02) 165-168
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Froehlich RJ, Sandoval G, Bailit JL. et al; MSCE, for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Association of recorded estimated fetal weight and cesarean delivery in attempted vaginal delivery at term. Obstet Gynecol 2016; 128 (03) 487-494
    CrossrefPubMedGoogle Scholar
  • 22 Martin JA, Wilson EC, Osterman MJK, Saadi EW, Sutton SR, Hamilton BE. Assessing the quality of medical and health data from the 2003 birth certificate revision: results from two states. Natl Vital Stat Rep 2013; 62 (02) 1-19
    Google Scholar
  • 23 Magro-Malosso ER, Saccone G, Chen M, Navathe R, Di Tommaso M, Berghella V. Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials. BJOG 2017; 124 (03) 414-421
    CrossrefPubMedGoogle Scholar
  • 24 Chauhan SP, Cole J, Laye MR. et al. Shoulder dystocia with and without brachial plexus injury: experience from three centers. Am J Perinatol 2007; 24 (06) 365-371
    Article in Thieme ConnectPubMedGoogle Scholar