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Shoulder Dystocia during Delivery and Long-Term Neurological Morbidity of the Offspring

Ziv Harari1, Omri Zamstein2, Eyal Sheiner1

  • 1Goldman School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

American Journal of Perinatology
|September 7, 2019
PubMed

Insights

Shoulder dystocia (SD) risk factors include fetal macrosomia, maternal diabetes, male gender, and advanced maternal age. Importantly, SD does not appear to increase long-term neurological risks for offspring.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Neurology
  • Perinatal Epidemiology

Background:

  • Shoulder dystocia (SD) is a rare but significant obstetric complication.
  • Understanding risk factors and long-term implications for offspring neurological outcomes is crucial for clinical practice.

Purpose of the Study:

  • To identify risk factors associated with shoulder dystocia.
  • To evaluate the impact of shoulder dystocia on the neurological outcomes of live-born infants up to 18 years of age.

Main Methods:

  • A large cohort analysis of 207,571 deliveries was conducted.
  • General estimation equation multivariable analyses identified risk factors for SD.
  • Kaplan-Meier curves and Cox proportional hazards models assessed cumulative neurological hospitalization incidence and controlled for confounders.

Main Results:

  • Shoulder dystocia occurred in 0.2% of deliveries.
  • Identified risk factors for SD included fetal macrosomia, maternal diabetes mellitus, male infant gender, and advanced maternal age (p < 0.05).
  • Despite higher perinatal mortality in SD cases, no significant differences in neurological conditions or cumulative neurological-related hospitalizations were observed between SD and non-SD groups (adjusted HR = 0.73; p = 0.381).

Conclusions:

  • Fetal macrosomia, maternal diabetes, male gender, and advanced maternal age are significant risk factors for shoulder dystocia.
  • Shoulder dystocia is not associated with increased long-term neurological morbidity in offspring.
Abstract

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