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Maternal and neonatal outcomes of large for gestational age pregnancies.
Acta Obstet Gynecol Scand. 2012 Jul; 91(7):844-9.AO

Abstract

OBJECTIVE

To compare maternal and neonatal outcomes of term large for gestational age (LGA) pregnancies and adequate for gestational age (AGA) pregnancies.

DESIGN

Retrospective analysis.

SETTING

Large university research medical center.

POPULATION

All term singleton LGA (birthweight ≥ 90th percentile) and AGA pregnancies (birthweight 10.1-89.9th percentile) delivering between 2004 and 2008.

METHODS

Data collected included maternal age, gestational age at delivery, mode of delivery, birthweight, fetal sex, and maternal and neonatal complications. Birthweight percentiles were determined according to locally derived gender-specific birthweight tables.

MAIN OUTCOME MEASURES

Comparisons between LGA and AGA pregnancies and between LGA 90-94.9th, 95-98.9th and ≥ 99th percentile.

RESULTS

The study population comprised 34 685 pregnancies; 3900 neonates matched the definition of term LGA. Maternal age and gestational age at delivery were significantly higher for LGA neonates. Significantly more LGA neonates were born by cesarean section, and significantly more LGA pregnancies were complicated by postpartum hemorrhage (PPH), shoulder dystocia or neonatal hypoglycemia, and had a longer hospitalization period. Maternal and neonatal risks increased as birthweight increased from the 90-94.9th to 95-98.9th to ≥ 99th percentile. Specifically, the risks of shoulder dystocia (odds ratio 2.61, 3.35 and 5.11, respectively), PPH (odds ratio 1.81, 2.12 and 3.92, respectively) and neonatal hypoglycemia (odds ratio 2.53, 3.8 and 5.19, respectively) all increased linearly with birthweight percentile.

CONCLUSIONS

Large for gestational age pregnancies are associated with an increased rate of cesarean section, PPH, shoulder dystocia and neonatal hypoglycemia, as well as longer hospitalization. These risks increase as the birth percentile rises. These risks need to be emphasized in pre-delivery counseling.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel HaShomer, Israel. alinabrenner@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22471810

Citation

Weissmann-Brenner, Alina, et al. "Maternal and Neonatal Outcomes of Large for Gestational Age Pregnancies." Acta Obstetricia Et Gynecologica Scandinavica, vol. 91, no. 7, 2012, pp. 844-9.
Weissmann-Brenner A, Simchen MJ, Zilberberg E, et al. Maternal and neonatal outcomes of large for gestational age pregnancies. Acta Obstet Gynecol Scand. 2012;91(7):844-9.
Weissmann-Brenner, A., Simchen, M. J., Zilberberg, E., Kalter, A., Weisz, B., Achiron, R., & Dulitzky, M. (2012). Maternal and neonatal outcomes of large for gestational age pregnancies. Acta Obstetricia Et Gynecologica Scandinavica, 91(7), 844-9. https://doi.org/10.1111/j.1600-0412.2012.01412.x
Weissmann-Brenner A, et al. Maternal and Neonatal Outcomes of Large for Gestational Age Pregnancies. Acta Obstet Gynecol Scand. 2012;91(7):844-9. PubMed PMID: 22471810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and neonatal outcomes of large for gestational age pregnancies. AU - Weissmann-Brenner,Alina, AU - Simchen,Michal J, AU - Zilberberg,Eran, AU - Kalter,Anat, AU - Weisz,Boaz, AU - Achiron,Reuven, AU - Dulitzky,Mordechai, Y1 - 2012/04/30/ PY - 2012/4/5/entrez PY - 2012/4/5/pubmed PY - 2012/9/21/medline SP - 844 EP - 9 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 91 IS - 7 N2 - OBJECTIVE: To compare maternal and neonatal outcomes of term large for gestational age (LGA) pregnancies and adequate for gestational age (AGA) pregnancies. DESIGN: Retrospective analysis. SETTING: Large university research medical center. POPULATION: All term singleton LGA (birthweight ≥ 90th percentile) and AGA pregnancies (birthweight 10.1-89.9th percentile) delivering between 2004 and 2008. METHODS: Data collected included maternal age, gestational age at delivery, mode of delivery, birthweight, fetal sex, and maternal and neonatal complications. Birthweight percentiles were determined according to locally derived gender-specific birthweight tables. MAIN OUTCOME MEASURES: Comparisons between LGA and AGA pregnancies and between LGA 90-94.9th, 95-98.9th and ≥ 99th percentile. RESULTS: The study population comprised 34 685 pregnancies; 3900 neonates matched the definition of term LGA. Maternal age and gestational age at delivery were significantly higher for LGA neonates. Significantly more LGA neonates were born by cesarean section, and significantly more LGA pregnancies were complicated by postpartum hemorrhage (PPH), shoulder dystocia or neonatal hypoglycemia, and had a longer hospitalization period. Maternal and neonatal risks increased as birthweight increased from the 90-94.9th to 95-98.9th to ≥ 99th percentile. Specifically, the risks of shoulder dystocia (odds ratio 2.61, 3.35 and 5.11, respectively), PPH (odds ratio 1.81, 2.12 and 3.92, respectively) and neonatal hypoglycemia (odds ratio 2.53, 3.8 and 5.19, respectively) all increased linearly with birthweight percentile. CONCLUSIONS: Large for gestational age pregnancies are associated with an increased rate of cesarean section, PPH, shoulder dystocia and neonatal hypoglycemia, as well as longer hospitalization. These risks increase as the birth percentile rises. These risks need to be emphasized in pre-delivery counseling. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/22471810/Maternal_and_neonatal_outcomes_of_large_for_gestational_age_pregnancies_ DB - PRIME DP - Unbound Medicine ER -