Subscribe to RSS
DOI: 10.1055/a-1673-5455
The Rate of Intrapartum Cesarean Delivery Based on Estimated Fetal Weight in Comparison to Previous Child's Birth Weight
Funding None.![](https://www.thieme-connect.de/media/ajp/202403/lookinside/thumbnails/10-1055-a-1673-5455_210415-1.jpg)
Abstract
Objective The aim of the study is to examine whether an estimated fetal weight of the current pregnancy greater than previous birth weight is associated with increased odds of intrapartum cesarean delivery.
Study Design We conducted a retrospective cohort study of all women who had more than one singleton pregnancy at 23 weeks' gestation or greater at a single labor and delivery unit. We only analyzed the second pregnancy in the dataset. We excluded women who had preterm birth in the second pregnancy. Women were categorized according to the difference between estimated fetal weight and previous birth weight—estimated fetal weight close to previous birth weight within 500 g (similar weight group); estimated fetal weight significantly (more than 500 g) greater than previous birth weight (larger weight group); and estimated fetal weight significantly (more than 500 g) lower than previous birth weight (smaller weight group). The primary outcome was intrapartum cesarean delivery. Multivariable logistic regression was performed to calculate adjusted odds ratios (aORs) with 95% confidence interval (95% confidence interval [CI]) after adjusting for predefined covariates.
Results Of 1,887 women, there were 1,415 (75%) in the similar weight group, 384 (20%) in the greater weight group, and 88 (5%) in the smaller weight group. Individuals in the larger weight group compared with those in the similar weight group had higher odds of undergoing intrapartum cesarean delivery (11.2 vs. 4.5%; aOR 2.91; 95% CI 1.91–4.45). The odds of intrapartum cesarean delivery in the smaller weight group compared with those in the similar weight group were not increased (3.4 vs. 4.5%; crude OR 0.75; 95%CI 0.23–2.42).
Conclusion The difference between current estimated fetal weight and previous birth weight plays an important role in assessing the risk of intrapartum cesarean delivery.
Key Points
-
Estimated fetal weight compared with previous birth weight is an important factor.
-
Cesarean delivery is infrequent if estimated fetal weight is similar to previous birth weight.
-
Larger estimated fetal weight greater than the previous birth weight is associated with cesarean delivery.
Keywords
estimated fetal weight - intrapartum cesarean delivery - previous birth weight - proven pelvisPublication History
Received: 29 May 2021
Accepted: 05 October 2021
Accepted Manuscript online:
19 October 2021
Article published online:
02 December 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.
-
References
- 1 Martin JA, Hamilton BE, Osterman MJK, Driscoil AK. Births: Final Data for 2019. National Vital Statistics Reports; vol. 70 no 2. Hyattsville, MD: National Center for Health Statistics; 2021
- 2 Deneux-Tharaux C, Carmona E, Bouvier-Colle MH, Bréart G. Postpartum maternal mortality and cesarean delivery. Obstet Gynecol 2006; 108 (3 Pt 1): 541-548
- 3 MacDorman MF, Declercq E, Menacker F, Malloy MH. Neonatal mortality for primary cesarean and vaginal births to low-risk women: application of an “intention-to-treat” model. Birth 2008; 35 (01) 3-8
- 4 Curtin SC, Gregory KD, Korst LM, Uddin SF. Maternal morbidity for vaginal and cesarean deliveries, according to previous cesarean history: new data from the birth certificate, 2013. Natl Vital Stat Rep 2015; 64 (04) 1-13
- 5 Silver RM, Landon MB, Rouse DJ. et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 2006; 107 (06) 1226-1232
- 6 Hu HT, Xu JJ, Lin J. et al. Association between first caesarean delivery and adverse outcomes in subsequent pregnancy: a retrospective cohort study. BMC Pregnancy Childbirth 2018; 18 (01) 273
- 7 Smith GC, Pell JP, Dobbie R. Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet 2003; 362 (9398): 1779-1784
- 8 Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014; 123: 693-711
- 9 Froehlich RJ, Sandoval G, Bailit JL. et al; MSCE, for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Association of recorded estimated fetal weight and cesarean delivery in attempted vaginal delivery at term. Obstet Gynecol 2016; 128 (03) 487-494
- 10 Dude AM, Grobman WA, Yee LM. Association between sonographic estimated fetal weight and the risk of cesarean delivery among nulliparous women with diabetes in pregnancy. Am J Perinatol 2018; 35 (13) 1297-1302
- 11 Macrosomia. ACOG practice bulletin no. 216. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020; 135: e18-e35
- 12 Osterman MJ, Martin JA. Changes in cesarean delivery rates by gestational age: United States, 1996-2011. NCHS Data Brief 2013; (124) 1-8
- 13 Goetzinger KR, Odibo AO, Shanks AL, Roehl KA, Cahill AG. Clinical accuracy of estimated fetal weight in term pregnancies in a teaching hospital. J Matern Fetal Neonatal Med 2014; 27 (01) 89-93
- 14 Kawakita T, Franco S, Ghofranian A, Thomas A, Landy HJ. Interpregnancy body mass index change and risk of intrapartum cesarean delivery. Am J Perinatol 2021; 38 (08) 759-765
- 15 WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization 2018 Accessed March 29, 2021 at: https://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf
- 16 Pattinson RC, Cuthbert A, Vannevel V. Pelvimetry for fetal cephalic presentations at or near term for deciding on mode of delivery. Cochrane Database Syst Rev 2017; 3: CD000161
- 17 Grobman WA, Lai Y, Landon MB. et al; National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU). Development of a nomogram for prediction of vaginal birth after cesarean delivery. Obstet Gynecol 2007; 109 (04) 806-812
- 18 Chauhan SP, Hendrix NW, Magann EF, Morrison JC, Kenney SP, Devoe LD. Limitations of clinical and sonographic estimates of birth weight: experience with 1034 parturients. Obstet Gynecol 1998; 91 (01) 72-77
- 19 Kayem G, Grangé G, Bréart G, Goffinet F. Comparison of fundal height measurement and sonographically measured fetal abdominal circumference in the prediction of high and low birth weight at term. Ultrasound Obstet Gynecol 2009; 34 (05) 566-571