The association between birthweight 4000 g or greater and perinatal outcomes in patients with and without gestational diabetes mellitus.
OBJECTIVE
The objective of the study was to examine the association between birthweight of 4000 g or greater and perinatal outcomes in women with and without gestational diabetes mellitus (GDM).


METHODS
This was a retrospective cohort study of 36,241 singleton pregnancies stratified by the diagnosis of GDM, with presence or absence of birthweight of 4000 g or greater. Outcomes examined included neonatal hyperbilirubinemia, hypoglycemia, respiratory distress syndrome (RDS), shoulder dystocia, and Erb's palsy. chi(2) tests and multivariable logistic regression analyses were used to control for confounders.


RESULTS
In women with GDM, neonates with a birthweight of 4000 g or greater, compared with those with a birthweight of less than 4000 g, had higher frequencies of hypoglycemia (5.3% vs 2.6%; P = .04), RDS (4.0% vs 1.5%; P = .03), shoulder dystocia (10.5% vs 1.6%; P < .001), and Erb's palsy (2.6% vs 0.2%; P < .001). Even without GDM, these outcomes occurred more frequently in infants with birthweight of 4000 g or greater. GDM increases the odds of adverse outcomes associated with birthweight of 4000 g or greater, particularly shoulder dystocia (adjusted odds ratios [aORs], 16.4 [GDM] vs 9.6 [non-GDM] and Erb's palsy (aORs, 41.9 [GDM] vs 6.7 [non-GDM]).


CONCLUSIONS
Birthweight of 4000 g or greater is associated with a higher incidence of adverse perinatal outcomes such that neonatal providers should be alerted.
Esakoff
Tania F
TF
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, School of Medicine, San Francisco, CA, USA.
Cheng
Yvonne W
YW
Sparks
Teresa N
TN
Caughey
Aaron B
AB
D001724:Birth Weight; D015331:Cohort Studies; D016640:Diabetes, Gestational; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies