The Association of High Birth Weight with Pregnancy Outcomes: a Longitudinal Study
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MEDICINE
The Association of High Birth Weight with Pregnancy Outcomes: a Longitudinal Study Francisco Amor Valera 1 & Mireia Bernal Claverol 1 & Santiago Garcia-Tizon Larroca 1 Accepted: 13 August 2020 / Published online: 18 August 2020 # Springer Nature Switzerland AG 2020
Abstract To explore the adverse perinatal results associated with high birth weight (HBW) and analyse other risk factors associated with these events. This was a retrospective longitudinal study of all childbirths occurring in our maternity centre during the period of 2010–2016. A comparative analysis was performed between pregnancy outcomes of newborns with weights above the 95th percentile and newborns with normal weight. In addition, a multivariate logistic regression analysis was performed to evaluate the risk factors associated with the identified adverse perinatal events. The perinatal results of 31,576 deliveries were analysed. When the two groups were compared, the group of pregnancies with HBW newborns showed higher frequencies of maternal diabetes, induction of labour, stalled labour caesarean section, severe perineal tears, and type 3 or greater neonatal resuscitation and a higher maternal age (p < 0.05). The multivariate regression analysis identified HBW as an important risk factor for stalled labour caesarean section and severe perineal tears, with odds ratios (ORs) of 3.6 (95% confidence interval (CI), 3.08–4.2) and 2.06 (95% CI, 1.33–3.19), respectively. Other risk factors such as induction of labour, gestational diabetes and instrument-assisted delivery (p < 0.001) were identified. Deliveries of newborns with weights above the 95th percentile presented poorer perinatal results compared to deliveries of normal weight newborns. This study identified additional relevant risk factors associated with stalled labour caesarean section and severe perineal tears. These findings could be useful to provide adequate advice to pregnant women. Keywords High birth weight . Macrosomia . Perinatal outcome . Caesarean section . Perineal tear
Abbreviations HBW high birth weight AGA weight adequate for their gestational age CRL crown-rump length CTG cardiotocography CSAL stalled labour/suspected cephalopelvic disproportion caesarean section
Background Neonatal macrosomia or HBW currently represents a challenge for obstetricians due to the increased risk of perinatal This article is part of the Topical Collection on Medicine * Santiago Garcia-Tizon Larroca [email protected] 1
Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Julio Palacios 2, 28029 Madrid, ES, Spain
complications, such as postpartum haemorrhage, shoulder dystocia, an increased risk of caesarean section (and its associated complications), perineal trauma, neonatal asphyxia, cerebral haemorrhage in the newborn or even neonatal death [1–3]. In addition, several studies have shown a greater risk of developing metabolic pathology and obesity during adult life in children who were born with HBW [4]. This comp
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