title: Labor and Delivery Experiences of Mothers with Suspected Large Babies.
abstract: OBJECTIVE
  To characterize the prevalence of and factors associated with clinicians' prenatal suspicion of a large baby; and to determine whether communicating fetal size concerns to patients was associated with labor and delivery interventions and outcomes.
  
  
  METHODS
  We examined data from women without a prior cesarean who responded to Listening to Mothers III, a nationally representative survey of women who had given birth between July 2011 and June 2012 (n = 1960). We estimated the effect of having a suspected large baby (SLB) on the odds of six labor and delivery outcomes.
  
  
  RESULTS
  Nearly one-third (31.2%) of women were told by their maternity care providers that their babies might be getting "quite large"; however, only 9.9% delivered a baby weighing ≥4000 g (19.7% among mothers with SLBs, 5.5% without). Women with SLBs had increased adjusted odds of medically-induced labor (AOR 1.9; 95% CI 1.4-2.6), attempted self-induced labor (AOR 1.9; 95% CI 1.4-2.7), and use of epidural analgesics (AOR 2.0; 95% CI 1.4-2.9). No differences were noted for overall cesarean rates, although women with SLBs were more likely to ask for (AOR 4.6; 95% CI 2.8-7.6) and have planned (AOR 1.8; 95% CI 1.0-4.5) cesarean deliveries. These associations were not affected by adjustment for gestational age and birthweight.
  
  
  CONCLUSIONS
  Only one in five US women who were told that their babies might be getting quite large actually delivered infants weighing ≥4000 g. However, the suspicion of a large baby was associated with an increase in perinatal interventions, regardless of actual fetal size.
authors.affiliation: Division of General Academic Pediatrics, Harvard Medical School and Massachusetts General Hospital for Children, 100 Cambridge Street, 1570-B5, Boston, MA, 02114, USA. ercheng@mgh.harvard.edu.
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, 810 Massachusetts Avenue, CT430, Boston, MA, 02118, USA. declercq@bu.edu.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Declercq
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, 810 Massachusetts Avenue, CT429, Boston, MA, 02118, USA. cbelanoff@bu.edu.
authors.forename: Candice
authors.initials: C
authors.lastname: Belanoff
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, San Francisco General Hospital, University of California, San Francisco, 3333 California Street, San Francisco, CA, 94118, USA. stotlandn@obgyn.ucsf.edu.
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Stotland
authors.affiliation: Department of Obstetrics and Gynecology, Boston University School of Medicine, 10 Grove Street, East Boston, MA, 02128, USA. Ronald.Iverson@bmc.org.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Iverson
mesh_terms: D001724:Birth Weight; D036861:Delivery, Obstetric / Q000523:psychology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008016:Life Change Events; D011247:Pregnancy; D014219:Trial of Labor
keywords: Labor induction; Mode of delivery; Suspected macrosomia