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Matern Child Health J. 2015 Dec;19(12):2578-86. doi: 10.1007/s10995-015-1776-0.

Labor and Delivery Experiences of Mothers with Suspected Large Babies.

Author information

  • 1Division of General Academic Pediatrics, Harvard Medical School and Massachusetts General Hospital for Children, 100 Cambridge Street, 1570-B5, Boston, MA, 02114, USA. ercheng@mgh.harvard.edu.
  • 2Department of Community Health Sciences, Boston University School of Public Health, 810 Massachusetts Avenue, CT430, Boston, MA, 02118, USA. declercq@bu.edu.
  • 3Department of Community Health Sciences, Boston University School of Public Health, 810 Massachusetts Avenue, CT429, Boston, MA, 02118, USA. cbelanoff@bu.edu.
  • 4Department of Obstetrics, Gynecology, and Reproductive Science, San Francisco General Hospital, University of California, San Francisco, 3333 California Street, San Francisco, CA, 94118, USA. stotlandn@obgyn.ucsf.edu.
  • 5Department of Obstetrics and Gynecology, Boston University School of Medicine, 10 Grove Street, East Boston, MA, 02128, USA. Ronald.Iverson@bmc.org.

Abstract

OBJECTIVE:

To characterize the prevalence of and factors associated with clinicians' prenatal suspicion of a large baby; and to determine whether communicating fetal size concerns to patients was associated with labor and delivery interventions and outcomes.

METHODS:

We examined data from women without a prior cesarean who responded to Listening to Mothers III, a nationally representative survey of women who had given birth between July 2011 and June 2012 (n = 1960). We estimated the effect of having a suspected large baby (SLB) on the odds of six labor and delivery outcomes.

RESULTS:

Nearly one-third (31.2%) of women were told by their maternity care providers that their babies might be getting "quite large"; however, only 9.9% delivered a baby weighing ≥4000 g (19.7% among mothers with SLBs, 5.5% without). Women with SLBs had increased adjusted odds of medically-induced labor (AOR 1.9; 95% CI 1.4-2.6), attempted self-induced labor (AOR 1.9; 95% CI 1.4-2.7), and use of epidural analgesics (AOR 2.0; 95% CI 1.4-2.9). No differences were noted for overall cesarean rates, although women with SLBs were more likely to ask for (AOR 4.6; 95% CI 2.8-7.6) and have planned (AOR 1.8; 95% CI 1.0-4.5) cesarean deliveries. These associations were not affected by adjustment for gestational age and birthweight.

CONCLUSIONS FOR PRACTICE:

Only one in five US women who were told that their babies might be getting quite large actually delivered infants weighing ≥4000 g. However, the suspicion of a large baby was associated with an increase in perinatal interventions, regardless of actual fetal size.

KEYWORDS:

Labor induction; Mode of delivery; Suspected macrosomia

PMID:
26140835
[PubMed - in process]
PMCID:
PMC4644447
Free PMC Article
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