title: Shoulder dystocia: a comparison of patients with and without diabetes mellitus.
abstract: BACKGROUND
  The study was aimed to compare pregnancies complicated with shoulder dystocia, of patients with and without diabetes mellitus.
  
  
  METHODS
  A comparison of all singleton, vertex, term deliveries between the years 1988-1999, complicated with shoulder dystocia with and without diabetes mellitus was performed. Statistical analysis was done using receiver operating characteristic curve analysis.
  
  
  RESULTS
  Using a receiver operating characteristic curve analysis, the area under the curve for birth weight was 0.92 (95% CI 0.90-0.93). However, for birth weight of 4,000 g the sensitivity was only 56% with specificity of 95%. While comparing shoulder dystocia between patients with (n=38) and without diabetes mellitus (n=207), neonates of the diabetic patients were significantly heavier (mean birth weight 4,244.2+/-515.1 vs. 4,051.6+/-389.5; P=0.008) and had higher rate of Apgar scores lower than 7 at 1 min (50.0% vs. 25.9%; P=0.030), but not at 5 min (2.6% vs. 2.0%; P=0.083) when compared to the non-diabetic group. No significant differences were noted regarding perinatal mortality between the groups (0% vs. 4.3%; P=0.362).
  
  
  CONCLUSIONS
  The newborn of the diabetic mother complicated with shoulder dystocia does not appear to be at an increased risk for perinatal morbidity compared with the newborn of the non-diabetic mother.
authors.affiliation: Epidemiology and Health Services Evaluation Department, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
authors.forename: Rachel D
authors.initials: RD
authors.lastname: Hammel
authors.forename: Reli
authors.initials: R
authors.lastname: Hershkovitz
authors.forename: Mordechai
authors.initials: M
authors.lastname: Hallak
authors.forename: Miriam
authors.initials: M
authors.lastname: Katz
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
mesh_terms: D000328:Adult; D001034:Apgar Score; D019540:Area Under Curve; D048909:Diabetes Complications; D004420:Dystocia / Q000209:etiology*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012782:Shoulder