Population-Based Risk Factors for Shoulder Dystocia.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatal Research

Background:

• Rising rates of maternal obesity and diabetes present challenges in obstetric care.
• Shoulder dystocia remains a significant risk during childbirth, necessitating updated risk factor analysis.

Purpose of the Study:

• To re-evaluate risk factors for shoulder dystocia in pregnant women.
• To identify key predictors in the context of increasing maternal comorbidities.

Main Methods:

• Retrospective observational study of 19,236 births across five US hospitals.
• Analysis of electronic medical records using a generalized linear mixed model.

Main Results:

• Insulin-treated gestational diabetes (OR=2.10) and epidural anesthesia (OR=3.47) were associated with increased shoulder dystocia risk.
• Other risk factors included Black or Hispanic ethnicity, Medicaid/no insurance, and gestational age ≥41 weeks.

Conclusions:

• Clinicians face increasing numbers of high-risk pregnancies for shoulder dystocia.
• Findings aid in prospectively identifying women at greatest risk for this obstetric complication.