Shoulder dystocia: a comparison of patients with and without diabetes mellitus

Arch Gynecol Obstet. 2006 Jan;273(4):203-6. doi: 10.1007/s00404-005-0051-9. Epub 2005 Oct 20.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Apgar Score
  • Area Under Curve
  • Diabetes Complications*
  • Dystocia / etiology*
  • Female
  • Fetal Macrosomia / etiology
  • Fetal Macrosomia / physiopathology*
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Pregnancy in Diabetics*
  • ROC Curve
  • Retrospective Studies
  • Risk Factors
  • Shoulder