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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / Dimitrou, G. / Grunebaum, G. E. / Hentschel, Roland / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, MD, PhD, HonD, Istvan / Vetter, Klaus / Young, Bruce K. / Zimmermann, Roland / Köpcke, W.

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Birth injury in a subsequent vaginal delivery among women with a history of shoulder dystocia

1 / Jason D. Soh1 / Luis A. Menacho1 / Melissa A. Schiff1, 2 / Susan D. Reed1, 3

1Department of Epidemiology, University of Washington, Seattle, USA

2Harborview Injury Prevention and Research Center, Seattle, USA

3Department Obstetrics and Gynecology, University of Washington, Seattle, USA

Corresponding author: Danny V. Colombara, MPH Department of Epidemiology Box # 357236 University of Washington School of Public Health Seattle, WA 98195 USA

Citation Information: Journal of Perinatal Medicine. Volume 39, Issue 6, Pages 709–715, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/jpm.2011.074, July 2011

Publication History

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Aim: To examine risk factors for birth injury in a subsequent vaginal delivery among women with a prior delivery complicated by shoulder dystocia.

Methods: Population-based retrospective cohort study, Washington State (1987–2007). Logistic regression was used to assess risk factors associated with subsequent birth injury.

Results: Of 9232 women who met inclusion criteria, 223 (2.4%) had a subsequent vaginal delivery with birth injury. Birth injury in an index delivery, adjusted odds ratio (aOR) 2.6 [95% confidence interval (CI) 1.7–4.1] and factors in subsequent delivery: birth weight ≥4000 g, aOR 4.4 (95% CI: 3.0–6.3), gestational diabetes, aOR 1.9 (95% CI: 1.2–3.2), Hispanic ethnicity aOR 1.9 (95% CI: 1.2–2.9), and maternal obesity, aOR 1.8 (95% CI: 1.3–2.6) were associated with birth injury.

Conclusion: Among women with prior delivery complicated by shoulder dystocia, the risk factors identified in this study should be carefully considered prior to deciding upon route of delivery – cesarean vs. vaginal delivery.

Keywords: Birth injuries; diabetes; dystocia; fetal macrosomia; gestational; risk factors

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