Accelerated fetal growth velocity across the third trimester is associated with increased shoulder dystocia risk among fetuses who are not large-for-gestational-age: A prospective observational cohort study

MacDonald, Teresa M.; Robinson, A.; Hiscock, Richard; Hui, Lisa; Dane, Kirsten M.; Middleton, Anna; Kennedy, Lucy M.; Tong, Stephen; Walker, Susan

doi:10.1371/journal.pone.0258634

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…EFW can help to take appropriate precautions and minimize harm. In the study of Mourad et al and also in the study of MacDonald T. et al it was shown that the risk of SD was higher in groups with high EFW [16,17].…”

Section: Discussionmentioning

confidence: 83%

Risk Factors in Prediction of Shoulder Distocia

Kose¹,

Baran

OZBEK³

et al. 2022

Preprint

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Purpose The aim of this study was to evaluate the maternal, obstetric, and fetal risk factors, shoulder dystocia maneuvers, and perinatal outcomes of shoulder dystocia cases. Methods In this descriptive retrospective cross-sectional study, 66 documented shoulder dystocia (incidence 0.18%) groups from 36390 singleton vaginal deliveries between 2017 and 2022 in a gynecology&obstetrics hospital and 201 control groups selected from the computer-assisted randomization program on pregnancy, delivery, fetal and newborn outcomes data were evaluated and compared. Regression analysis were used to explain the relationship between the shoulder dystocia and risk factors. Results Mean age was significantly higher in the shoulder dystocia group (p < 0.05). In the stepwise binary logistic regression model analysis, hemoglobin level, abdominal circumference, femur length, estimated fetal weight, birth weight and second stage of labor were found to be significant risk factors for shoulder dystocia (p < 0.05). Measurement of abdominal circumference (sensitivity 81.8%, specificity 91.0%) and birth weight (sensitivity 62.4%, specificity 91.5%) were found to be the most significant risk factors for shoulder dystocia, while the other risk factors had low sensitivity (< 60.0%). Conclusion The low sensitivity of shoulder dystocia risk factors other than birth weight and abdominal circumference measurement indicates that the unpredictable feature of shoulder dystocia is preserved.

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Section: Discussionmentioning

confidence: 83%

Risk Factors in Prediction of Shoulder Distocia

Kose¹,

Baran

OZBEK³

et al. 2022

Preprint

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“…In pregnant women, large babies are associated with prolonged labor and delivery, increased rates of vaginal obstruction and cesarean section, and a range of complications including postpartum hemorrhage. The fetus is also at increased risk for shoulder dystocia, brachial plexus injury, hypoglycemia, and even asphyxia, as well as for adult health status, including obesity and cardiovascular disease [ 4 , 5 , 27 ]. Therefore, early detection of high-risk pregnant women and timely pregnancy care and guidance are of great importance to prevent the development of huge babies and promote maternal and infant health.…”

Section: Discussionmentioning

confidence: 99%

“…However, the incidence of macrosomia varies greatly among different regions in China, averaging about 7%-9% [ 2 , 3 ]. Neonatal weight affects the delivery mode of pregnant women and can increase the risk of assisted delivery, dystocia, neonatal birth injury, birth canal injury, and other risks for vaginal delivery, as well as the incidence of neonatal asphyxia [ 4 , 5 ]. At present, the mechanism of macrosomia is not clear, and the occurrence of macrosomia is usually the result of multiple factors [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Analytical Comparison of Risk Prediction Models for the Onset of Macrosomia Based on Three Statistical Methods

Zhang

Song

2022

Disease Markers

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Background and Purpose. Fetal overgrowth can pose a serious threat to the safety of a mother and child. Early identification of high-risk pregnant women and timely pregnancy intervention and guidance are of great value in preventing the development of giant babies and improving adverse maternal and infant outcomes. The current clinical methods for predicting macrosomia mainly rely on obstetric examination and imaging, but their accuracy is controversial. And there is no accepted method for accurately predicting macrosomia. We investigated the risk factors influencing the occurrence of macrosomia and established a prediction model for the occurrence of macrosomia to provide a reference basis for interventions to prevent macrosomia. Method. A retrospective selection of 93 women who were hospitalized in our hospital from March 2019 to May 2022 with a singleton pregnancy and delivered at term with macrosomia were the study group. And 356 women who delivered a normal size baby during the same period were the control group. The variables that were associated with the onset of macrosomia were screened from maternal medical records. Logistic regression models, random forest, and CART decision tree models were developed using the screened variables as input variables and whether they were macrosomia as outcome variables, respectively. The performance of the three models was evaluated by accuracy, precision, recall, F1 score, and receiver operating characteristic curve (ROC). Result. The risk prediction models for the onset of macrosomia, logistic regression model, random forest model, and decision tree, were successfully developed, with accuracies of 0.904, 1.000, and 0.901 in the training set and 0.926, 0.582, and 0.852 in the validation set, respectively. The AUC in the training set were 0.898, 1.000, and 0.789, and in the validation set were 0.906, 0.913, and 0.731, respectively. In general, the logistic regression model has the highest diagnostic efficiency, followed by the random forest model. Conclusion. Logistic regression models have high application value in the assessment of predicting the risk of macrosomia, and it is suggested that the advantages of logistic regression models and random forest models should be combined in future studies and applications to make them work better in the prediction of the risk of macrosomia.

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“…Singleton pregnancies at the 36-week scan will be included because this study aims to provide evidence for a late pregnancy ultrasound screening strategy to prevent stillbirths, perinatal mortality and adverse neurodevelopmental outcomes. Although the gestational age widow constituting the 36-week scan varies,35–40 this study will include systematic reviews with obstetric scans from 34+0 weeks gestation. This study will not be limited to any context or language.…”

Section: Methodsmentioning

confidence: 99%

Late pregnancy ultrasound parameters identifying fetuses at risk of adverse perinatal outcomes: a protocol for a systematic review of systematic reviews

Aderoba

Nasir²,

Quigley

et al. 2022

BMJ Open

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IntroductionStillbirths and neonatal deaths are leading contributors to the global burden of disease and pregnancy ultrasound has the potential to help decrease this burden. In the absence of high-Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence on universal obstetric ultrasound screening at or close to term, many different screening strategies have been proposed. Systematic reviews have rapidly increased over the past decade owing to the diverse nature of ultrasound parameters and the wide range of possible adverse perinatal outcomes. This systematic review will summarise the evidence on key ultrasound parameters in the published literature to help develop an obstetric ultrasound protocol that identifies pregnancies at risk of adverse perinatal outcomes at or close to term.MethodsThis study will follow the recent Cochrane guidelines for a systematic review of systematic reviews. A comprehensive literature search will be conducted using Embase (OvidSP), Medline (OvidSP), CDSR, CINAHL (EBSCOhost) and Scopus. Systematic reviews evaluating at least one ultrasound parameter in late pregnancy to detect pregnancies at risk of adverse perinatal outcomes will be included. Two independent reviewers will screen, assess the quality including the risk of bias using the ROBIS tool, and extract data from eligible systematic reviews that meet the study inclusion criteria. Overlapping data will be assessed and managed with decision rules, and study evidence including the GRADE assessment of the certainty of results will be presented as a narrative synthesis as described in the Cochrane guidelines for an overview of reviews.Ethics and disseminationThis research uses publicly available published data; thus, an ethics committee review is not required. The findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42021266108.

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Accelerated fetal growth velocity across the third trimester is associated with increased shoulder dystocia risk among fetuses who are not large-for-gestational-age: A prospective observational cohort study

Cited by 9 publications

References 22 publications

Risk Factors in Prediction of Shoulder Distocia

Risk Factors in Prediction of Shoulder Distocia

Analytical Comparison of Risk Prediction Models for the Onset of Macrosomia Based on Three Statistical Methods

Late pregnancy ultrasound parameters identifying fetuses at risk of adverse perinatal outcomes: a protocol for a systematic review of systematic reviews

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