Revista Chilena de Obstetricia y Ginecología (Jan 2005)
MORBILIDAD FETAL ASOCIADA AL PARTO EN MACROSÓMICOS: ANÁLISIS DE 3981 NACIMIENTOS
Abstract
Objetivo: Determinar la incidencia de traumatismos asociados al parto y la capacidad, de distintas categorías de peso macrosómico, de predecir una mayor frecuencia de estos traumatismos. Diseño: Estudio retrospectivo. Lugar: Servicio de Maternidad del Hospital Clínico de la Universidad de Chile. Participantes: 3981 nacimientos atendidos desde enero de 2001 a Diciembre de 2003. Resultados evaluados: Tasa de traumatismos asociados al parto. Resultados: La incidencia global de traumatismos asociados al parto fue 0,65%, significativamente más alta en parto vaginal operatorio (1,5%) y vaginal normal (0,7%), en relación a cesáreas (0,2% )(pObjective: To determine the incidence of morbidity associated with macrosomic delivery, and the ability to predict a higher frequency of morbidity for distinct categories of macrosomia. Study design: We analyzed 3981 births from January 2001 to December 2003, at the Maternity Ward from the University of Chile Clinical Hospital. Afterward, we analyzed the rate of morbidity and mortality associated with route of delivery between different categories of birth weigh. Results: The overall incidence of morbidity associated with delivery was 0.65%, and was significantly higher in operative vaginal delivery (1.5%) and normal vaginal delivery (0.7%) compared to cesareans (0.2%, p<0.009). The odds ratio (OR) for birth trauma in macrosomic newborns was 3.12 (95% CI 1.34-7.21) and the OR of death during delivery in grade 1 macrosomics (4000-4999 g) was 15.6 (95% CI, 1.41-172.37). The OR for cesarean delivery by grade of macrosomia were: Grade 1 (4000-4499 g) 2.07 (95% CI, 1.53-2.36); Grade 2 (4500-4999 g) 4.13 (95% CI, 2.13-7.98); Grade 3 (³5000 g) 5.59 (95% CI, 0.58-53.9). Conclusions: Fetal macrosomia is an important predictor of cesarean delivery and of a higher neonatal morbidity and fetal mortality during delivery
