Maternal and neonatal outcomes of large for gestational age pregnancies

Alina Weissmann-Brenner*, Michal J. Simchen, Eran Zilberberg, Anat Kalter, Boaz Weisz, Reuven Achiron, Mordechai Dulitzky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

148 Scopus citations

Abstract

Objective. To compare maternal and neonatal outcomes of termlarge 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 termLGA.Maternal age and gestational age at delivery were significantly higher for LGA neonates. Significantlymore 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.

Original languageEnglish
Pages (from-to)844-849
Number of pages6
JournalActa Obstetricia et Gynecologica Scandinavica
Volume91
Issue number7
DOIs
StatePublished - Jul 2012
Externally publishedYes

Keywords

  • Cesarean section
  • Large for gestational age
  • Neonatal hypoglycemia
  • Perineal tear
  • Postpartum hemorrhage
  • Shoulder dystocia

Fingerprint

Dive into the research topics of 'Maternal and neonatal outcomes of large for gestational age pregnancies'. Together they form a unique fingerprint.

Cite this