Prediction of risk for shoulder dystocia with neonatal injury

The purpose of this study was to develop a predictive model of risk for shoulder dystocia (ShD) with injury. Medical records in 3 urban university teaching hospitals were reviewed to identify and characterize 498 cases of ShD, including 90 with neonatal injury and a comparison group with of 622 with...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2006-12, Vol.195 (6), p.1544-1549
Main Authors: Dyachenko, Alina, Ciampi, Antonio, Fahey, Jenifer, Mighty, Hugh, Oppenheimer, Lawrence, Hamilton, Emily F.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Birth Injuries - etiology
Birth Weight
Body Height
Body Weight
Brachial Plexus - injuries
Brachial plexus injury
Delivery. Postpartum. Lactation
Disorders
Dystocia - etiology
Epidemiology
False Positive Reactions
Female
General aspects
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
Labor Presentation
Medical sciences
Models, Statistical
Mothers
Parity
Prediction
Pregnancy
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Assessment
Shoulder
Shoulder dystocia
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Summary:The purpose of this study was to develop a predictive model of risk for shoulder dystocia (ShD) with injury. Medical records in 3 urban university teaching hospitals were reviewed to identify and characterize 498 cases of ShD, including 90 with neonatal injury and a comparison group with of 622 with vaginal delivery (VgD) without ShD. The data were subjected to logistic regression modeling to find the best combination of variables to discriminate between the injury and VgD groups. The best model included birth weight in combination with maternal height and weight as well as gestational age and parity. A score over 0.5 detected 50.7% of the shoulder dystocia cases with brachial plexus injury along with a false positive rate of 2.7%. Using a statistical model it is possible to identify adverse combinations of factors that are associated with ShD and neonatal injury along with a relatively low false positive rate.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2006.05.013