Maternal and neonatal outcomes of large for gestational age pregnancies
Acta Obstetricia et Gynecologica Scandinavica, 07/23/2012
WEISSMANN–BRENNER A ., et al. – 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.Methods
- Retrospective analysis, Large university research medical center
- 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.
- 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, PPH and neonatal hypoglycemia all increased linearly with birthweight percentile.