Incidence trends of shoulder dystocia and associated risk factors: A nationwide analysis in the United States

Youssefzadeh, Ariane C.; Tavakoli, Amin; Panchal, Viraj R.; Mandelbaum, Rachel S.; Ouzounian, Joseph G.; Matsuo, Koji

doi:10.1002/ijgo.14699

Cited by 5 publications

(5 citation statements)

References 23 publications

(84 reference statements)

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“…All hospital deliveries, both vaginal deliveries and cesarean sections, in pregnant patients aged 15–54 years between January 2016 and December 2019 were abstracted from the dataset. The age cutoffs were based on recent studies 12,13 . The World Health Organization's International Classification of Disease 10th edition (ICD‐10) Clinical Modification codes were used to define the presence of adenomyosis as well as delineate additional diagnoses and procedures performed within the index hospital admission.…”

Section: Methodsmentioning

confidence: 99%

“…The age cutoffs were based on recent studies. 12 , 13 The World Health Organization's International Classification of Disease 10th edition (ICD‐10) Clinical Modification codes were used to define the presence of adenomyosis as well as delineate additional diagnoses and procedures performed within the index hospital admission. The exposure was based on the presence or absence of adenomyosis (ICD‐10 clinical modification code N80.0).…”

Section: Methodsmentioning

confidence: 99%

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The association between uterine adenomyosis and adverse obstetric outcomes: A propensity score‐matched analysis

Mandelbaum

Melville

Violette

et al. 2023

Acta Obstet Gynecol Scand

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Introduction This study examined obstetric outcomes in patients diagnosed with uterine adenomyosis. Material and methods This historical cohort study queried the Healthcare Cost and Utilization Project's National Inpatient Sample. The study population was all hospital deliveries in women aged 15–54 years between January 2016 and December 2019. The exposure was a diagnosis of uterine adenomyosis. The main outcome measures were obstetric characteristics, including placenta previa, placenta accreta spectrum, and placental abruption. Secondary outcomes were delivery complications including severe maternal morbidity. Analytic steps to assess these outcomes included (i) a 1‐to‐N propensity score matching to mitigate and balance prepregnancy confounders to assess obstetric characteristics, followed by (ii) an adjusting model with preselected pregnancy and delivery factors to assess maternal morbidity. Sensitivity analyses were also performed with restricted cohorts to account for prior uterine scar, uterine myoma, and extra‐uterine endometriosis. Results After propensity score matching, 5430 patients with adenomyosis were compared to 21 720 patients without adenomyosis. Adenomyosis was associated with an increased odds of placenta accreta spectrum (adjusted‐odds ratio [aOR] 3.07, 95% confidence interval [CI] 2.01–4.70), placenta abruption (aOR 3.21, 95% CI: 2.60–3.98), and placenta previa (aOR 5.08, 95% CI: 4.25–6.06). Delivery at <32 weeks of gestation (aOR 1.48, 95% CI: 1.24–1.77) and cesarean delivery (aOR 7.72, 95% CI: 7.04–8.47) were both increased in women with adenomyosis. Patients in the adenomyosis group were more likely to experience severe maternal morbidity at delivery compared to those in the nonadenomyosis group (aOR 1.86, 95% CI: 1.59–2.16). Results remained robust in the aforementioned several sensitivity analyses. Conclusions This national‐level analysis suggests that a diagnosis of uterine adenomyosis is associated with an increased risk of placental pathology (placenta accreta spectrum, placenta abruption, and placental previa) and adverse maternal outcomes at delivery.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The association between uterine adenomyosis and adverse obstetric outcomes: A propensity score‐matched analysis

Mandelbaum

Melville

Violette

et al. 2023

Acta Obstet Gynecol Scand

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“… 14 Identification of vaginal and cesarean deliveries followed the schema of prior studies (Table 1). 5,15,16 Patient age was limited to 15–54 years according to prior analyses 17,18 …”

Section: Methodsmentioning

confidence: 99%

“…5,15,16 Patient age was limited to 15-54 years according to prior analyses. 17,18 salpingectomy were increased in patients with breast cancer (aOR 3.01), cervical cancer (aOR 2.26) or lymphoma (aOR 2.08). The odds of proceeding with bilateral tubal ligation in pregnant patients aged <30 with melanoma (aOR 5.36) was also increased.…”

Section: Study Populationmentioning

confidence: 99%

Contraception and sterilization selection at delivery among pregnant patients with malignancy

Harris

Mandelbaum

Rau

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionSince malignancy during pregnancy is uncommon, information regarding contraception selection or sterilization at delivery is limited. The objective of this study was to examine the type of long‐acting reversible contraception or surgical sterilization procedure chosen by pregnant patients with malignancy at delivery.Material and methodsThis cross‐sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample in the USA. The study population was vaginal and cesarean deliveries in a hospital setting from January 2017 to December 2020. Pregnant patients with breast cancer (n = 1605), leukemia (n = 1190), lymphoma (n = 1120), thyroid cancer (n = 715), cervical cancer (n = 425) and melanoma (n = 400) were compared with 14 265 319 pregnant patients without malignancy. The main outcome measures were utilization of long‐acting reversible contraception (subdermal implant or intrauterine device) and performance of permanent surgical sterilization (bilateral tubal ligation or bilateral salpingectomy) during the index hospital admission for delivery, assessed with a multinomial regression model controlling for clinical, pregnancy and delivery characteristics.ResultsWhen compared with pregnant patients without malignancy, pregnant patients with breast cancer were more likely to proceed with bilateral salpingectomy (adjusted odds ratio [aOR] 2.30) or intrauterine device (aOR 1.91); none received the subdermal implant. Pregnant patients with leukemia were more likely to choose a subdermal implant (aOR 2.22), whereas those with lymphoma were more likely to proceed with bilateral salpingectomy (aOR 1.93) and bilateral tubal ligation (aOR 1.76). Pregnant patients with thyroid cancer were more likely to proceed with bilateral tubal ligation (aOR 2.21) and none received the subdermal implant. No patients in the cervical cancer group selected long‐acting reversible contraception, and they were more likely to proceed with bilateral salpingectomy (aOR 2.08). None in the melanoma group chose long‐acting reversible contraception. Among pregnant patients aged <30, the odds of proceeding with bilateral salpingectomy were increased in patients with breast cancer (aOR 3.01), cervical cancer (aOR 2.26) or lymphoma (aOR 2.08). The odds of proceeding with bilateral tubal ligation in pregnant patients aged <30 with melanoma (aOR 5.36) was also increased.ConclusionsThe results of this nationwide assessment in the United States suggest that among pregnant patients with malignancy, the preferred contraceptive option or method of sterilization at time of hospital delivery differs by malignancy type.

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“…Previous research indicates that gestational weight gain is one of the primary risk factors for delivering an infant with macrosomia. [13][14][15] Numerous studies have explored the correlation between gestational diabetes, gestational weight gain, and adverse clinical outcomes. Existing clinical guidelines have provided recommendations regarding gestational weight acquisition.…”

Section: Introductionmentioning

confidence: 99%

Association between percentage change in gestational weight and macrosomia in a diabetic maternal population

Chen,

Sun,

et al. 2024

Preprint

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Background Numerous clinical studies have investigated the relationship between maternal gestational weight-related parameters and macrosomia in infants. However, research on the association between the percentage change in gestational weight and macrosomia in infants is lacking. Additionally, the existing clinical guidelines do not offer specific recommendations for gestational weight control in pregnant women with diabetes to prevent macrosomia deliveries. Objective This study aimed to investigate the relationship between the percentage change in gestational weight and macrosomia deliveries in pregnant women with diabetes. Study Design: This retrospective cohort study included routine obstetric examination and baseline clinical data of pregnant women with gestational diabetes mellitus who visited the Third Affiliated Hospital of Wenzhou Medical University between January 2019 and December 2020. The diagnosis of gestational diabetes mellitus was based on the criteria outlined by the International Association of Diabetes and Pregnancy Study Groups in 2010. The percentage change in gestational weight was calculated using the following formula: pre-delivery weight–pre-pregnancy weight) / pre-pregnancy weight. Macrosomia was defined as a birth weight greater than or equal to 4000 g. Continuous variables were analyzed using one-way analysis of variance or the Kruskal-Wallis rank-sum test, categorical variables were assessed using Fisher's exact probability test, and univariate analysis was used to evaluate the relationship between each variable and macrosomia deliveries. Results This study included 316 patients diagnosed with gestational diabetes mellitus, of whom 57 delivered infants diagnosed with macrosomia. In the unadjusted, partially, and fully adjusted models, a significant correlation was found between percentage change in gestational weight and macrosomia deliveries (odds ratio = 39.6, 95% confidence interval: 1.8-866.3, P = 0.019; odds ratio = 1344.9, 95% confidence interval: 35.4-51118.2, P < 0.001; odds ratio = 1139.7, 95% confidence interval: 0.9-1523385.0, P = 0.055), respectively. After adjusting for potential confounding factors (age, maternal place of birth, height, pre-pregnancy body mass index, history of macrosomia deliveries, fetal sex, pre-delivery hemoglobin A1c, pre-delivery triglycerides, pre-delivery apolipoprotein B, pre-delivery high-density lipoprotein, pre-delivery glucose, number of full-term deliveries, neonatal birth length, gestational age at delivery), a non-linear relationship was noted between the percentage change in gestational weight and macrosomia, with an inflection point at 0.18. Conclusion Results showed a strong correlation between the percentage change in gestational weight and macrosomia deliveries in our population of women with gestational diabetes mellitus; a non-linear relationship was found between the percentage change in gestational weight and macrosomia delivery. This result suggests a significant increase in the probability of macrosomia delivery when the change in gestational weight exceeds 18%.

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Incidence trends of shoulder dystocia and associated risk factors: A nationwide analysis in the United States

Cited by 5 publications

References 23 publications

The association between uterine adenomyosis and adverse obstetric outcomes: A propensity score‐matched analysis

The association between uterine adenomyosis and adverse obstetric outcomes: A propensity score‐matched analysis

Contraception and sterilization selection at delivery among pregnant patients with malignancy

Association between percentage change in gestational weight and macrosomia in a diabetic maternal population

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