The influence of macrosomia on the duration of labor, the mode of delivery and intrapartum complications

Siggelkow, W.; Boehm, Daniel; Skala, Christine; Grosslercher, M.; Schmidt, M; Koelbl, Heinz

doi:10.1007/s00404-008-0630-7

Cited by 55 publications

(45 citation statements)

References 17 publications

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“…Women delivering macrosomic infants more often experiences a number of adverse birth outcome (109-112) and prolonged labor (110). Prolonged second stage of labor may increase the risk of postpartum hemorrhage (113), the incidence of acute cesarean section (114) or vaginal operative delivery (111). Delivering of a macrosomic fetus also increases the risk of third or fourth degree lacerations (110).…”

Section: Maternal Health Consequences Short Term Risksmentioning

confidence: 99%

Modifiable determinants of fetal macrosomia: role of lifestyle‐related factors

Voldner

Frøslie²,

Bø

et al. 2008

Acta Obstet Gynecol Scand

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Background. Newborn macrosomia is associated with both short‐ and long‐term health risks for the infant, and increases the prevalence of birth complications. Parity, maternal age and gender of the child are known variables that influence fetal growth. The purpose of the present investigation was to evaluate prospectively the contributions of modifiable maternal predictors of fetal macrosomia (≥4,200 g), which included lifestyle‐related factors, such as nutritional intake, physical activity, and plasma glucose values, in addition to overweight and pregnancy weight gain. Methods. Some 553 women were followed through pregnancy. Predictive variables were subjected to univariate and multiple logistic regression analysis. Among these were: body mass index (BMI), weight gain, maternal subcutaneous fat (mm), fasting and 2‐h plasma glucose, self‐reported physical activity before and during pregnancy, and nutritional intake of macronutrients. Gestational age, parity and gender were also included in the model. All continuous variables were dichotomized using the upper quartile as the cut‐off point in most cases. Results. If physical activity was left out of the analyses, BMI, weight gain, plasma glucose and gestational age were independent determinants of macrosomia. After including low level pre‐gestational physical activity in the model, we found that this was now a significant determinant of delivering a macrosomic infant with an OR = 2.9 (95% CI: 1.9, 7.3). Conclusion. The present study indicates that a low level of pre‐gestational physical activity adds to the modifiable determinants of newborn macrosomia.

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Section: Maternal Health Consequences Short Term Risksmentioning

confidence: 99%

Modifiable determinants of fetal macrosomia: role of lifestyle‐related factors

Voldner

Frøslie²,

Bø

et al. 2008

Acta Obstet Gynecol Scand

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“…A high ratio indicates a large placental weigh relative to birth weight. All singleton pregnancies in Norway from 1999 through 2004 (n = 308 717) [3][4][5]8,15 We also found a positive association of high birthweight, but after adjustment for placental weight, the association of birthweight was strongly attenuated. It has been suggested that impaired uterine contractions may occur more often after deliveries of large babies, and one consequence of this could be a longstanding postpartum haemorrhage.…”

Section: Discussionmentioning

confidence: 79%

“…3,[6][7][8][9][10] A large placenta will typically have a large surface area attached to the uterine wall, and it is therefore conceivable that large placental size is associated with increased risk of excess postpartum haemorrhage. Such an association may partly explain why women who deliver large babies are at higher risk of postpartum haemorrhage 5 because birthweight and placental weight are strongly correlated. 11 We hypothesised that placental weight is positively associated with excess postpartum haemorrhage also after adjustment for offspring birth size and other risk factors of excess postpartum haemorrhage.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Previous research suggests that parity, high offspring birthweight, labour dystocia and caesarean section are factors that may increase the risk of excess haemorrhage. [4][5][6][7][8][9] In addition, complications that are closely linked to the placenta, including placenta praevia, placental abruption, as well as a retained placenta and pre-eclampsia, have been related to excess postpartum haemorrhage. 3,[6][7][8][9][10] A large placenta will typically have a large surface area attached to the uterine wall, and it is therefore conceivable that large placental size is associated with increased risk of excess postpartum haemorrhage.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Placental weight and excess postpartum haemorrhage: a population study of 308 717 pregnancies

Eskild

Vatten

2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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“…Excessive invasion by EVT can also be detrimental in cases such as placenta accreta. High birth weight is potentially dangerous to both mother and baby through prolonged obstructed labour [5,6] with risk of asphyxia and injury in the baby [7][8][9], and lacerations and post-partum haemorrhage in the mother [5,9]. It is therefore crucially important that this process is carefully regulated maintaining a balance between over and under invasion.…”

mentioning

confidence: 99%

KIR and HLA-C: Immunogenetic regulation of human birth weight

Farrell¹,

Hiby²,

Apps³

et al. 2014

Nor J Epidemiol

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Pregnancies resulting in very small or very large babies are at higher risk of obstetric complications with increased morbidity for both mother and baby. Using data from the Medical Birth Registry of Norway we have shown how human birth weight is still subject to stabilizing selection. Particular combinations of maternal/fetal immune genes have been implicated in pregnancies resulting in a low birth weight baby (<5 th birth weight centile). More specifically, an inhibitory maternal KIRAA genotype with a paternally derived fetal HLA-C2 ligand. At the other end of the birth weight spectrum the presence of an activating maternal KIR2DS1 gene is associated with increased birth weight in linear or logistic regression analyses of all pregnancies >5 th centile (p=0.005, OR=2.65). Thus, inhibitory maternal KIR combined with fetal HLA-C2 is more frequently associated with low birth weight, whereas activating maternal KIR with fetal HLA-C2 ligand is associated with increasing birth weight. Our findings using the MoBa cohort have replicated the association of KIR and HLA-C seen in poor placentation, and confirm the importance of maternal/fetal immune gene interactions in determining the outcome of pregnancy.This is an open access article distributed under the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The influence of macrosomia on the duration of labor, the mode of delivery and intrapartum complications

Abstract: As some of the risk factors identified are known prior to delivery, every woman in whom there is a suspicion that the fetus may weigh up to 4,500 g should receive individual guidance regarding special intrapartum and perinatal conditions.

Cited by 55 publications

References 17 publications

Modifiable determinants of fetal macrosomia: role of lifestyle‐related factors

Modifiable determinants of fetal macrosomia: role of lifestyle‐related factors

Placental weight and excess postpartum haemorrhage: a population study of 308 717 pregnancies

KIR and HLA-C: Immunogenetic regulation of human birth weight

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