Geburtshilfe Frauenheilkd 2014; 74 - PO_Geb04_05
DOI: 10.1055/s-0034-1388086

Maternal obesity and shoulder dystocia: a retrospective cohort analysis of 13,083 deliveries

CHG Cirkel 1, I Indorf 1, DA Beyer 1
  • 1Universitätsklinikum Schleswig-Holstein/Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany

Objective: Studies show, that the strongest predictors of shoulder dystocia are related to fetal macrosomia. Maternal obesity, high maternal weight gain and diabetes are also risk factors on shoulder dystocia in spontaneous deliveries. This study examined the rate of shoulder dystocia of different BMI groups in deliveries occurred at the Obstetrical department of the University Hospital Schleswig-Holstein/Luebeck.

Materials and methods: The factor “shoulder dystocia” was searched for in a retrospective cohort analysis of n = 13,083 deliveries supervised between 01.01.2000 and 31.12.2011 at the Obstetrical department of the UKSH/HL. Patients have been divided into 2 main groups according to their BMI values: BMI18.5 – 24.9 and BMI > 25. Exclusion criteria: incomplete data, multiple pregnancy, BMI < 18.5.

Results: 11,227 patients delivered 11,816 children. The group “BMI > 18.5 – 24.9 kg/m2” included 7,271 (64.8%) patients and 7,673 (64.9%) born children. The rate of shoulder dystocia of that group was 8 (0.1%) cases. Group “BMI ≥25 kg/m2” included 3,955 (35.2%) patients and 4,143 (35.1%) born children with 7 (0.2%) cases of shoulder dystocia. There was no statistically significant difference between the two BMI groups concerning shoulder dystocia.

Increased BMI was associated with significantly more secondary c-sections and less spontaneous deliveries. Fetal birth weight, height and head circumference were significantly increased in patients with higher BMI (p < 0.001).

Conclusion: Shoulder dystocia occurred in 0.1% of the delivered children in all groups. The rate of shoulder dystocia in both BMI groups was not significantly different. A possible explanation might be that an increased BMI and fetal macrosomia was associated with a higher rate of secondary c-sections.