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Am J Obstet Gynecol. 1997 Jul;177(1):37-41.

Incidence of persistent birth injury in macrosomic infants: association with mode of delivery.

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  • 1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 94143-0556, USA.

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.

STUDY DESIGN:

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.

PMID:
9240580
[PubMed - indexed for MEDLINE]
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