Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more

Objective: To determine if shoulder dystocia can be predicted in babies born weighing 3.5 kg or more. Study design: A case-control study nested in a perinatal database of 899 mothers and their babies who weighed 3.5 kg or more. All were term pregnancies and delivered vaginally. A case was defined as...

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Main Authors: Mansor, A., Arumugam, K., Omar, S.Z.
Format: Article
Language:en
Published: 2010
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Online Access:http://eprints.um.edu.my/10849/1/Macrosomia_is_the_only_reliable_predictor_of_shoulder.pdf
http://eprints.um.edu.my/10849/
http://www.sciencedirect.com/science/article/pii/S0301211509007040
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author Mansor, A.
Arumugam, K.
Omar, S.Z.
author_facet Mansor, A.
Arumugam, K.
Omar, S.Z.
author_sort Mansor, A.
building UM Library
collection Institutional Repository
content_provider Universiti Malaya
content_source UM Research Repository
continent Asia
country Malaysia
description Objective: To determine if shoulder dystocia can be predicted in babies born weighing 3.5 kg or more. Study design: A case-control study nested in a perinatal database of 899 mothers and their babies who weighed 3.5 kg or more. All were term pregnancies and delivered vaginally. A case was defined as any baby that encountered shoulder dystocia at delivery. Controls were deliveries over the same period that were not complicated by shoulder dystocia. A logistic regression model was created with macrosomia, parity, previous delivery of more than 3.5 kg, diabetes in pregnancy, prolonged labor, prolonged second stage and instrumental delivery as the independent variables. The adjusted odds ratio and the receiver operator characteristics (ROC) curves were used to see if these variables, both individually and as a model, were associated with or were discriminative enough to predict shoulder dystocia; an ROC curve of more than 0.7 showing good prediction. Results: There were 36 cases of shoulder dystocia during the study period, an incidence of 4. Previous delivery of more than 3.5 kg, prolonged labor and prolonged second stage were not associated with shoulder dystocia. Although diabetes and instrumental delivery were independently and significantly associated with shoulder dystocia their importance as a predictor became relevant only in the presence of macrosomia. Conclusion: Macrosomia is the only reliable predictor of shoulder dystocia. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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spelling my.um.eprints-108492014-07-16T00:05:20Z http://eprints.um.edu.my/10849/ Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more Mansor, A. Arumugam, K. Omar, S.Z. R Medicine RG Gynecology and obstetrics Objective: To determine if shoulder dystocia can be predicted in babies born weighing 3.5 kg or more. Study design: A case-control study nested in a perinatal database of 899 mothers and their babies who weighed 3.5 kg or more. All were term pregnancies and delivered vaginally. A case was defined as any baby that encountered shoulder dystocia at delivery. Controls were deliveries over the same period that were not complicated by shoulder dystocia. A logistic regression model was created with macrosomia, parity, previous delivery of more than 3.5 kg, diabetes in pregnancy, prolonged labor, prolonged second stage and instrumental delivery as the independent variables. The adjusted odds ratio and the receiver operator characteristics (ROC) curves were used to see if these variables, both individually and as a model, were associated with or were discriminative enough to predict shoulder dystocia; an ROC curve of more than 0.7 showing good prediction. Results: There were 36 cases of shoulder dystocia during the study period, an incidence of 4. Previous delivery of more than 3.5 kg, prolonged labor and prolonged second stage were not associated with shoulder dystocia. Although diabetes and instrumental delivery were independently and significantly associated with shoulder dystocia their importance as a predictor became relevant only in the presence of macrosomia. Conclusion: Macrosomia is the only reliable predictor of shoulder dystocia. (C) 2009 Elsevier Ireland Ltd. All rights reserved. 2010 Article PeerReviewed application/pdf en http://eprints.um.edu.my/10849/1/Macrosomia_is_the_only_reliable_predictor_of_shoulder.pdf Mansor, A. and Arumugam, K. and Omar, S.Z. (2010) Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more. European Journal of Obstetrics & Gynecology and Reproductive Biology, 149 (1). pp. 44-46. ISSN 0301-2115, DOI https://doi.org/10.1016/j.ejogrb.2009.12.003 <https://doi.org/10.1016/j.ejogrb.2009.12.003>. http://www.sciencedirect.com/science/article/pii/S0301211509007040 10.1016/j.ejogrb.2009.12.003
spellingShingle R Medicine
RG Gynecology and obstetrics
Mansor, A.
Arumugam, K.
Omar, S.Z.
Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
title Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
title_full Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
title_fullStr Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
title_full_unstemmed Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
title_short Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
title_sort macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
topic R Medicine
RG Gynecology and obstetrics
url http://eprints.um.edu.my/10849/1/Macrosomia_is_the_only_reliable_predictor_of_shoulder.pdf
http://eprints.um.edu.my/10849/
http://www.sciencedirect.com/science/article/pii/S0301211509007040
url_provider http://eprints.um.edu.my/