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Am J Perinatol. 2018 Nov;35(13):1297-1302. doi: 10.1055/s-0038-1649482. Epub 2018 May 4.

Association between Sonographic Estimated Fetal Weight and the Risk of Cesarean Delivery among Nulliparous Women with Diabetes in Pregnancy.

Author information

1
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Abstract

OBJECTIVE:

The objective of this study was to examine the association between an ultrasound-estimated fetal weight (US-EFW) and mode of delivery among nulliparous diabetic women.

STUDY DESIGN:

This is a retrospective cohort study of nulliparous women with medication-requiring gestational or pregestational diabetes who delivered term, singleton gestations following a trial of labor. We determined whether having had an US-EFW within 35 days of delivery was associated with cesarean delivery.

RESULTS:

Of 304 women who met the eligibility criteria, 231 (76.0%) had an US-EFW within 35 days of delivery. An US-EFW was associated with increased likelihood of intrapartum cesarean (51.5% for those with an ultrasound vs. 27.4% for those without, p < 0.001); this finding persisted even when controlling for birth weight and other confounding factors (adjusted odds ratio: 2.23, 95% confidence interval: 1.16-4.28). Among women with a recent US-EFW, a diagnosis of a large-for-gestational-age (LGA) fetus was associated with overall intrapartum cesarean frequency (65.2% for women with an LGA fetus vs. 46.1% for those without, p = 0.009), but this association did not remain significant in multivariable models.

CONCLUSION:

An US-EFW within 35 days of delivery among nulliparous women with medication-requiring diabetes was positively associated with intrapartum cesarean delivery.

PMID:
29727881
PMCID:
PMC6196119
[Available on 2019-11-01]
DOI:
10.1055/s-0038-1649482

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