title: Obstetric and neonatal characteristics of pregnancy and delivery for infant birthweight ≥5.0 kg.
abstract: OBJECTIVE
  Infant birthweight ≥5.0 kg represents a significant risk factor for mother and neonate. The objective of this study was to examine the obstetric and neonatal outcome measures in a large cohort of such deliveries.
  
  
  METHODS
  The data used for this study were prospectively entered into an obstetric computerized database during the period 1989-2013. All pregnancies where the delivery resulted in an infant weighing ≥5.0 kg were identified. The results were retrospectively analyzed separately for parity, and a separate analysis was performed comparing the outcome measures observed in the earlier years of the study with those of the later years.
  
  
  RESULTS
  There were 73,796 deliveries in the time period of which there were n = 201 (0.3%) infants with birth weight ≥5.0 kg. The mean maternal body mass index (BMI) was in the obese category range (30.9 kg/m2) and the median gestation at delivery was 40.8 weeks. The cesarean delivery rate for nulliparous women was 56.3% and for parous women 30.8%. The overall rate of third degree perineal tears was 3.8%, the rate of shoulder dystocia was 4.6% and the rate of Erb's Palsy was 1.5%. There was a significant increase in cesarean delivery in the latter of the study (26.7% versus 43.0%, p = 0.02), due to an increase in the planned pre-labor cesarean deliveries (30.0 versus 12.9%, p = 0.005). There was no difference in adverse outcomes in both groups.
  
  
  CONCLUSIONS
  These findings describe the features of pregnancy associated with infant birthweight ≥5.0 kg, and outline reliable maternal and neonatal morbidity data for these pregnancies. In this cohort, there was no apparent benefit from increased planned pre-labor cesarean delivery rates.
authors.affiliation: a Department of Obstetrics and Gynecology , National University of Ireland Galway, Galway University Hospital , Galway , Ireland.
authors.forename: David A
authors.initials: DA
authors.lastname: Crosby
authors.affiliation: a Department of Obstetrics and Gynecology , National University of Ireland Galway, Galway University Hospital , Galway , Ireland.
authors.forename: Sahar
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: a Department of Obstetrics and Gynecology , National University of Ireland Galway, Galway University Hospital , Galway , Ireland.
authors.forename: Aminah
authors.initials: A
authors.lastname: Razley
authors.affiliation: a Department of Obstetrics and Gynecology , National University of Ireland Galway, Galway University Hospital , Galway , Ireland.
authors.forename: John J
authors.initials: JJ
authors.lastname: Morrison
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Macrosomia; neonatology; obstetrics: diagnosis and management