Incidence of persistent birth injury in macrosomic infants: association with mode of delivery.
Am J Obstet Gynecol
; 177(1): 37-41, 1997 Jul.
Article
in En
| MEDLINE
| ID: mdl-9240580
ABSTRACT
OBJECTIVE:
Our purpose was to determine the incidence of birth injury in a cohort of macrosomic infants (birth weight >4000 gm) and analyze the association between persistent injury and delivery method. STUDYDESIGN:
Deliveries of 2924 macrosomic infants were reviewed. Outcomes were compared with those of 16,711 infants with birth weights between 3000 and 3999 gm.RESULTS:
Macrosomic infants had a sixfold increase in significant injury relative to controls (relative risk 6.7,95% confidence interval 6.5 to 6.9). Risk of trauma correlated with delivery mode forceps were associated with a fourfold risk of clinically persistent findings compared with spontaneous vaginal delivery or cesarean section. However, the overall incidence of persistent cases remained low (0.3%); a policy of elective cesarean section for macrosomia would necessitate 148 to 258 cesarean sections to prevent a single persistent injury. Avoidance of operative vaginal delivery would require 50 to 99 cesarean sections per injury prevented.CONCLUSIONS:
These findings support a trial of labor and judicious operative vaginal delivery for macrosomic infants.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Birth Injuries
/
Fetal Macrosomia
/
Cesarean Section
/
Delivery, Obstetric
/
Extraction, Obstetrical
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Female
/
Humans
/
Newborn
/
Pregnancy
Language:
En
Journal:
Am J Obstet Gynecol
Year:
1997
Document type:
Article
Affiliation country:
Estados Unidos