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

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.

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Abstract

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.

Item Type:	Article
Funders:	UNSPECIFIED
Uncontrolled Keywords:	Shoulder dystocia; Prediction; ROC curves
Subjects:	R Medicine R Medicine > RG Gynecology and obstetrics
Divisions:	Faculty of Medicine
Depositing User:	Ms Haslinda Lahuddin
Date Deposited:	16 Jul 2014 00:05
Last Modified:	16 Jul 2014 00:05
URI:	http://eprints.um.edu.my/id/eprint/10849

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