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Determining factors associated with shoulder dystocia: a population-based study.
Eyal Sheiner1, Amalia Levy, Reli Hershkovitz
1Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel. sheiner.bgumail.bgu.ac.il
Summary
Shoulder dystocia risk factors include birth weight over 4000g, vacuum-assisted delivery, diabetes, and inadequate prenatal care. These factors significantly increase the likelihood of this obstetric complication.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Public Health
Background:
- Shoulder dystocia is a significant obstetric emergency with potential for severe neonatal and maternal morbidity.
- Identifying associated risk factors is crucial for risk stratification and management strategies.
Purpose of the Study:
- To determine independent obstetric factors associated with the occurrence of shoulder dystocia.
- To analyze the impact of identified risk factors on maternal and neonatal outcomes.
Main Methods:
- A population-based study comparing singleton, vertex, term deliveries with and without shoulder dystocia.
- Multiple logistic regression analysis was employed to identify independent risk factors.
Main Results:
- Shoulder dystocia occurred in 0.2% of deliveries.
- Independent risk factors identified: birth weight >= 4000g (OR 24.3), vacuum delivery (OR 5.7), diabetes mellitus (OR 1.7), and lack of prenatal care (OR 1.5).
- Shoulder dystocia was associated with increased rates of third-degree perineal tears, perinatal mortality, and low Apgar scores.
Conclusions:
- Birth weight >= 4000g, vacuum delivery, diabetes mellitus, and lack of prenatal care are significant independent predictors of shoulder dystocia.
- Combination of risk factors substantially elevates the risk of shoulder dystocia.