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Am J Perinatol 2018; 35(13): 1297-1302
DOI: 10.1055/s-0038-1649482
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association between Sonographic Estimated Fetal Weight and the Risk of Cesarean Delivery among Nulliparous Women with Diabetes in Pregnancy

Annie M. Dude
1   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
William A. Grobman
1   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Lynn M. Yee
1   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations
Funding L.M.Y. is supported by NICHD K12 HD050121-11. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Further Information

Publication History

12 September 2017

28 March 2018

Publication Date:
04 May 2018 (online)

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Abstract

Objective The objective of this study was to examine the association between an ultrasound-estimated fetal weight (US-EFW) and mode of delivery among nulliparous diabetic women.

Study Design This is a retrospective cohort study of nulliparous women with medication-requiring gestational or pregestational diabetes who delivered term, singleton gestations following a trial of labor. We determined whether having had an US-EFW within 35 days of delivery was associated with cesarean delivery.

Results Of 304 women who met the eligibility criteria, 231 (76.0%) had an US-EFW within 35 days of delivery. An US-EFW was associated with increased likelihood of intrapartum cesarean (51.5% for those with an ultrasound vs. 27.4% for those without, p < 0.001); this finding persisted even when controlling for birth weight and other confounding factors (adjusted odds ratio: 2.23, 95% confidence interval: 1.16–4.28). Among women with a recent US-EFW, a diagnosis of a large-for-gestational-age (LGA) fetus was associated with overall intrapartum cesarean frequency (65.2% for women with an LGA fetus vs. 46.1% for those without, p = 0.009), but this association did not remain significant in multivariable models.

Conclusion An US-EFW within 35 days of delivery among nulliparous women with medication-requiring diabetes was positively associated with intrapartum cesarean delivery.

Keywords

cesarean delivery - diabetes mellitus - estimated fetal weight - ultrasound

Note

A version of this article was presented at the Society for Maternal-Fetal Medicine Annual Meeting, January 2017, Las Vegas, NV.