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

Dude, Annie; Grobman, William A.; Yee, Lynn M.

doi:10.1055/s-0038-1649482

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…The common use of US to evaluate fetal weight increased the rate of CS even among pregnancies with lower EFW. Dude et al found an increased rate of CS among women who had US EFW 5 weeks prior to delivery, even after accounting for birth weight [ 178 ]. Among 304 diabetic pregnancies, 231 had US EFW, of them, 66 (28.6%) had the pre-delivery diagnosis of LGA.…”

Section: The Effects Of Diabetes In Pregnancy On the Newborn Infanmentioning

confidence: 99%

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Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Ornoy

Becker

Weinstein-Fudim³

et al. 2021

IJMS

178

101

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In spite of the huge progress in the treatment of diabetes mellitus, we are still in the situation that both pregestational (PGDM) and gestational diabetes (GDM) impose an additional risk to the embryo, fetus, and course of pregnancy. PGDM may increase the rate of congenital malformations, especially cardiac, nervous system, musculoskeletal system, and limbs. PGDM may interfere with fetal growth, often causing macrosomia, but in the presence of severe maternal complications, especially nephropathy, it may inhibit fetal growth. PGDM may also induce a variety of perinatal complications such as stillbirth and perinatal death, cardiomyopathy, respiratory morbidity, and perinatal asphyxia. GDM that generally develops in the second half of pregnancy induces similar but generally less severe complications. Their severity is higher with earlier onset of GDM and inversely correlated with the degree of glycemic control. Early initiation of GDM might even cause some increase in the rate of congenital malformations. Both PGDM and GDM may cause various motor and behavioral neurodevelopmental problems, including an increased incidence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Most complications are reduced in incidence and severity with the improvement in diabetic control. Mechanisms of diabetic-induced damage in pregnancy are related to maternal and fetal hyperglycemia, enhanced oxidative stress, epigenetic changes, and other, less defined, pathogenic mechanisms.

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Section: The Effects Of Diabetes In Pregnancy On the Newborn Infanmentioning

confidence: 99%

“…Among the 165 women with the pre-delivery diagnosis of EFW AGA, 6 (3.6%) were LGA. Pregnancies predicted to have an LGA infant were more likely to undergo a CS with the diagnosis of an arrest disorder [ 178 ].…”

Section: The Effects Of Diabetes In Pregnancy On the Newborn Infanmentioning

confidence: 99%

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Ornoy

Becker

Weinstein-Fudim³

et al. 2021

IJMS

178

101

View full text Add to dashboard Cite

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Indicated vs universal third-trimester ultrasound examination in low-risk pregnancies: a pre-post-intervention study

Roberts,

Hotra,

Soto

et al. 2024

American Journal of Obstetrics & Gynecology MFM

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The Rate of Intrapartum Cesarean Delivery Based on Estimated Fetal Weight in Comparison to Previous Child's Birth Weight

et al. 2021

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Objective: To examine whether an estimated fetal weight of the current pregnancy greater than previous birth weight is associated with increased odds of intrapartum cesarean delivery. Study design: We conducted a retrospective cohort study of all women who had more than one singleton pregnancy at 23 weeks’ gestation or greater at a single Labor and Delivery unit. We only analyzed the second pregnancy in the dataset. We excluded women who had preterm birth in the second pregnancy. Women were categorized according to the difference between estimated fetal weight and previous birth weight - estimated fetal weight close to previous birth weight within 500 grams (Similar Weight Group); estimated fetal weight significantly (more than 500 grams) greater than previous birth weight (Larger Weight Group); and estimated fetal weight significantly (more than 500 grams) lower than previous birth weight (Smaller Weight Group). The primary outcome was intrapartum cesarean delivery. Multivariable logistic regression was performed to calculate adjusted odds ratios (aOR) with 95% confidence interval (95%CI) after adjusting for predefined covariates. Results: Of 1,887 women, there were 1,415 (75%) in the Similar Weight Group, 384 (20%) in the Greater Weight Group, and 88 (5%) in the Smaller Weight Group. Individuals in the Larger Weight Group compared to those in the Similar Weight Group had higher odds of undergoing intrapartum cesarean delivery (11.2% vs. 4.5%; aOR 2.91; 95%CI 1.91-4.45). The odds of intrapartum cesarean delivery in the Smaller Weight Group compared to those in the Similar Weight Group were not increased (3.4% vs. 4.5%; crude OR 0.75; 95%CI 0.23-2.42). Conclusion: The difference between current estimated fetal weight and previous birth weight plays an important role in assessing the risk of intrapartum cesarean delivery.

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

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

Cited by 5 publications

References 24 publications

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Indicated vs universal third-trimester ultrasound examination in low-risk pregnancies: a pre-post-intervention study

The Rate of Intrapartum Cesarean Delivery Based on Estimated Fetal Weight in Comparison to Previous Child's Birth Weight

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