Increased incidence of shoulder dystocia in diabetic pregnancies at lower birth weights

M. H. Beall, M. J.M. Nijland, M. T. Cabahun, M. C. Rosy

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Diabetic pregnanc has been said to lie associated with an increased incidence ol' shoulder dvstocia, and with shoulder dystocia at lower birth weights. We used an objective definition of shoulder dystocia (Sdobj: head-to-body deliveiy time >60 see or use of obstetrical maneuvers to effect delivery) to evaluate the risk of this complication. STUDY DESIGN: Head-to-bod\ deliver, times (HBT) and use of maneuvers were routinely recorded by delivery room nurses and entered into an Ob database. Diabetes was defined bv '2 of 4 abnormal results on GTT. Comparisons between diabetic and non-diabetic (confirmed) pregnancies were made bv Chi square and Student's l tests. HBT and SDobj rates were evaluated for birth weight cohorts above 2500g. Data presented as mean ± SK. RESULTS: 39 diabetic and 069 non-diabetic pregnancies were recorded in tlir database. SDobj was diagnosed in 11% of diabetic pregnancies and in 5% ot nondiabetic pregnancies (p = 0.03). SDobj was increased in diabetic \s non-diabetic pregnancies at lower birth weight cohorts (2.5-3.5 kg; p < 0.05) though liiere was no difference at upper birth weight cohorts (3.5-4.5 kg; Figure). HBT increased in proportion with binh weight ( 18 ±5 to 54 ± 12 sec). CONCLUSIONS: (1) SDobj was more common in diabetic versus nondiabetic pregnancies. (2) The elevated raie ol SDobj in the lower birth weight diabetic pregnancies indicates that these pregnancies may be at an imappieriated high risk of traumatic delivery.

Original languageEnglish (US)
Pages (from-to)S137
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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