Correlation of birth weights with cesarean rates

Poma, Pedro A.

doi:10.1016/s0020-7292(98)00261-6

Cited by 19 publications

(13 citation statements)

References 11 publications

(1 reference statement)

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“…Since induced birth can be associated with a higher probability of cesarean sections [ 21 , 22 ], this might influence this statistical analysis. The influence of fetal birth weight on cesarean section rates is well known in cephalic deliveries [ 23 ] and thereby is not surprising in our breech cohort.…”

Section: Discussionmentioning

confidence: 57%

Maternal and neonatal outcome after vaginal breech delivery at term of children weighing more or less than 3.8 kg: A FRABAT prospective cohort study

et al. 2018

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IntroductionThe clinical management of breech presentations at term is still a controversially discussed issue among clinicians. Clear predictive criteria for planned vaginal breech deliveries are desperately needed to prevent adverse fetal and maternal outcomes and to reduce elective cesarean section rates. The green-top guideline considers an estimated birth weight of 3.8 kg or more an indication to plan a cesarean section despite the lack of respective evidence.ObjectiveTo compare maternal and neonatal outcome of vaginal intended breech deliveries of births with children with a birth weight of 2.5 kg– 3.79 kg and children with a birth weight of 3.8 kg and more.DesignProspective cohort study.SampleAll vaginal intended deliveries out of a breech position of newborns weighing between 2.5 kg and 4.5 kg at the Obstetrics department at Goethe University Hospital Frankfurt from January 2004 until December 2016MethodsNeonatal and maternal outcome of a light weight group (LWG) (< 3.8 kg) was compared to and a high weight group (HWG) (≥ 3.8 kg) using Pearson’s Chi Square test and Fishers exact test. A logistic regression analysis was performed to detect an association between cesarean section rates, fetal outcome and the birth weight.ResultsNo difference in neonatal morbidity was detected between the HWG (1.8%, n = 166) and the LWG (2.6%, n = 888). Cesarean section rate was significantly higher in the HWG with 45.2% in comparison to 28.8% in the LWG with an odds ratio of 1.57 (95% CI 1.29–1.91, p<0.0001). In vaginal deliveries, a high birth weight was not associated with an increased risk of maternal birth injuries (LWG in vaginal deliveries: 74.3%, HWG in vaginal deliveries: 73.6%; p = 0.887; OR = 1.9 (95% CI 0.9–1.1))ConclusionA fetal weight above 3.79 kg does not predict increased maternal or infant morbidity after delivery from breech presentation at term. Neither the literature nor our analyses document evidence for threshold of estimated birth weight that is associated with maternal and/or infant morbidity. However, patients should be informed about an increased likelihood of cesarean sections during labor when attempting vaginal birth from breech position at term in order to reach an informed shared decision concerning the birth strategy. Further investigations in multi center settings are needed to advance international guidelines on vaginal breech deliveries in the context of estimated birth weight and its impact on perinatal outcome.

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Section: Discussionmentioning

confidence: 57%

Maternal and neonatal outcome after vaginal breech delivery at term of children weighing more or less than 3.8 kg: A FRABAT prospective cohort study

et al. 2018

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“…Factors that have been associated with the progress of labor are epidural analgesia [17], oxytocin [18], fetal weight [19] and the presence of emotional support during labor [6]. The absence of conduction analgesia and an equal frequency of oxytocin use in labor enhancement will minimize the bias in this study.…”

Section: Discussionmentioning

confidence: 99%

Labor in the Grand Multipara

Lyrenäs¹

2002

Gynecol Obstet Invest

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Objective: To assess delivery time and the frequency of dystocia in grand multiparous (GMP) and grand grand multiparous (GGMP) women. Method: Labor records from 272 women with parity 4–8 (GMP) and 56 women with parity 9 or higher (GGMP) were retrospectively reviewed regarding duration of labor and the occurrence of dystocia. As a comparison, data from 263 women with parity 1–3 (LMP) and 87 nulliparas (NP) was used. Results: Duration of labor, defined as time from admission of the laboring woman to delivery of the infant, lasted in median 2.0, 2.3 and 3.1 h in LMP, GMP and GGMP, respectively. There was no difference in mean cervical dilatation on admission in multiparous women. In GGMP, the presenting part was more frequently positioned above the pelvic inlet at time of admission. In multiparous women admitted during the latent phase, the active phase of labor lasted in median 3.7 h in GMP and 4.7 h in GGMP, significantly longer than 2.9 h in LMP. During the active phase of labor, GGMP experienced arrest of cervical dilatation more frequently than the LMP. In parous women, there was a positive relationship between parity and duration of the active phase of labor as well as the duration of labor. Infant’s birth weight increased by parity. Conclusion: Duration of the active phase of labor increased after the fourth child. Failure of descent of the presenting part during the first stage of labor in addition to arrest of cervical dilatation was associated with a high cesarean section rate in the GMP woman.

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“…One possible reason we failed to detect an association is that the current Japanese Ministry of Health, Labour and Welfare guidelines are already quite strict 15 ; thus there is no benefit in further restriction. It is even possible that further restriction may lead to suboptimal growth of the fetus, leading to a possible increase in risk of cesarean section 18 . Indeed recent research suggested that weight gain recommended by the current national guidelines may be lower than what provides most optimal pregnancy outcomes 15 .…”

Section: Discussionmentioning

confidence: 99%

Association between women’s perceived ideal gestational weight gain during pregnancy and pregnancy outcomes

Ogawa

Morisaki

Sago

et al. 2018

Sci Rep

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We aimed to clarify which beliefs motivate women to control their weight during pregnancy and how such values influence pregnancy outcomes. Using a questionnaire administered during mid- to late- pregnancy in a hospital-based prospective cohort study, we explored women’s perceived ideal GWG and their reasons for having this ideal. Using multivariate regression, we evaluated the association between women’s perceived ideal GWG and pregnancy outcomes. Among 1,691 normal and underweight women, the most common reason women thought avoiding excessive weight gain was important was “for ease of delivery and/or her health and well-being”. 912 (54%) women wished to maintain their GWG below 12 kg, the upper limit recommended by the Japanese governmental guidelines, and had a lower actual GWG compared to those who had less stringent notions of GWG. Compared to women whose perceived ideal GWG was 12 kg, those who considered their perceived limit to be lower had infants with lower birthweight on average despite no significant reduction in cesarean delivery rate or post-partum body weight retention. Our findings suggest that women who believe they should limit their weight gain to an amount lower than the upper limit of current guidelines succeeded in gaining significantly less weight but received no additional benefit.

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Correlation of birth weights with cesarean rates

Cited by 19 publications

References 11 publications

Maternal and neonatal outcome after vaginal breech delivery at term of children weighing more or less than 3.8 kg: A FRABAT prospective cohort study

Maternal and neonatal outcome after vaginal breech delivery at term of children weighing more or less than 3.8 kg: A FRABAT prospective cohort study

Labor in the Grand Multipara

Association between women’s perceived ideal gestational weight gain during pregnancy and pregnancy outcomes

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