Secular trends in cesarean delivery rates among macrosomic deliveries in the United States, 1989 to 2002.
OBJECTIVE
We describe national trends in cesarean delivery rates among macrosomic infants during 1989 to 2000 and evaluate the maternal characteristics and risk factors for macrosomic infants delivered by cesarean section as compared to macrosomic infants delivered vaginally.


METHODS
We analyzed US 1989 to 2000 Natality files, selecting term (37 to 44 week) single live births to U.S. resident mothers. We compare macrosomic infants (4000 to 4499, 4500 to 4999 and 5000+ g infants) to a normosomic (3000 to 3999 g) control group.


RESULTS
The proportion of cesarean deliveries among 5000+ g infants increased significantly over the time period. The adjusted odds ratio of cesarean delivery increased for all macrosomic categories over the 12-year period, as compared to normal birth weight infants.


CONCLUSIONS
Rates of cesarean delivery among macrosomic infants continue to increase despite a lack of evidence of the benefits of cesarean delivery within this population. Further exploration of the rationale for this trend is warranted and should include the development of an optimal delivery strategy for such patients.
Boulet
Sheree L
SL
Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA.
Alexander
Greg R
GR
Salihu
Hamisu M
HM
D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005320:Fetal Macrosomia; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D014481:United States / Q000453:epidemiology