Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?

Karolina Passerini 1 , Juozas Kurmanavicius 2 , Tilo Burkhardt 2 ,  and Dalia Balsyte 2
  • 1 Department of Obstetrics and Gynecology, Kantonsspital Schaffhausen, Schaffhausen, Switzerland
  • 2 Department of Obstetrics, University Hospital of Zurich, Zürich, Switzerland
Karolina Passerini
  • Corresponding author
  • Department of Obstetrics and Gynecology, Kantonsspital Schaffhausen, Schaffhausen, Switzerland
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, Juozas Kurmanavicius, Tilo Burkhardt and Dalia Balsyte

Abstract

Objectives

Aim of the study was to analyze the impact of head circumference (HC) and birth weight (BW) on the delivery mode and delivery outcomes.

Methods

Study population consisted of pregnancy, delivery and newborn data from 1,762 women, who delivered between 2004 and 2016 at University Hospital of Zurich (UHZ). Odds ratio (OR) with 95% confidence intervals (CI) were calculated for mode of delivery. Newborns were sorted into four groups according HC or BW. To evaluate the association between HC and delivery outcome, a descriptive analysis was performed. In addition reference charts of newborn HC at term were constructed.

Results

OR for instrumental delivery (ID) was 2.37 (CI 95%, 1.63–3.46), for C-Section (CS) 3.74 (CI 95%, 1.49–9.37) when HC >36 cm. OR for ID was 1.59 (CI 95%, 1.02–2.50), for CS 3.18 (CI 95% 1.08–9.350) when BW was >4,000 g. OR for ID was 2.15 (95% CI, 1.69–2.73), for CS 1.93 (95% CI, 0.89–4.18) when HC ≥36 cm and BW <4000 g. OR for ID was 2.23 (95% CI, 1.35–3.67), for CS 4.39 (95% CI, 1.48–12.99) when HC ≥36 cm and BW ≥4,000 g. HC ≥36 cm was defined as large in our study. Mothers with higher age and body mass index delivered babies with larger HC (p<0.05). Blood loss and duration of expulsion period and BW was associated with larger HC (p<0.05).

Conclusions

The rate of ID and CS increased in case of a larger HC and greater BW. However, the main prognostic factor for ID was size of HC: ≥36 cm, but not macrosomia.

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