Sonographic markers of increased fetal adiposity demonstrate an increased risk for Cesarean delivery

Simple item page
dc.check.date2020-03-18
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorHehir, Mark P.
dc.contributor.authorBurke, Naomi
dc.contributor.authorBurke, Gerard J.
dc.contributor.authorTurner, Michael
dc.contributor.authorBreathnach, Fionnuala M.
dc.contributor.authorMcAuliffe, Fionnuala M.
dc.contributor.authorMorrison, John J.
dc.contributor.authorDornan, Samina
dc.contributor.authorHiggins, John R.
dc.contributor.authorCotter, Amanda
dc.contributor.authorGeary, Michael P.
dc.contributor.authorMcParland, Peter
dc.contributor.authorDaly, Sean
dc.contributor.authorCody, Fiona
dc.contributor.authorDicker, Patrick
dc.contributor.authorTully, Elizabeth
dc.contributor.authorMalone, Fergal D.
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2019-04-26T11:26:38Z
dc.date.available2019-04-26T11:26:38Z
dc.date.issued2019-03-18
dc.date.updated2019-03-27T10:03:46Z
dc.description.abstractOBJECTIVE: Increased fetal size is associated with labor dystocia and subsequent need for assisted delivery. We sought to investigate if increased fetal adiposity diagnosed sonographically was associated with increased risk of operative delivery. METHOD: The Genesis Study recruited 2,392 nulliparous patients with a vertex presentation in a prospective multicenter study to examine prenatal and intra‐partum predictors of cesarean delivery. Participants had ultrasound and clinical evaluation performed between 39 0/7 and 40 6/7 weeks’ gestation. Data on fetal biometry was not revealed either to patients or their managing clinicians. A fetal adiposity composite of fetal thigh adiposity and fetal abdominal thickness was compiled for each infant in order to clarify if fetal adiposity >90th centile was associated with an increased risk of cesarean or instrumental delivery. RESULTS: After exclusions data were available for 2,330 patients. Patients with a fetal adiposity composite >90th centile had a higher maternal BMI (24±4 vs. 25±5; p=0.005), birthweight (3872 ± 417g vs. 3585 ± 401g; p<0.0001) and rate of induction of labor (47% [108/232] vs. 40% [834/2098]; p=0.048) than those patients with an adiposity composite ≤90th centile. Fetuses with adiposity composite >90th centile were more likely to require cesarean delivery than fetuses with adiposity <90th centile (p<0.0001). After adjusting for birthweight, maternal BMI, and onset of labor, fetal adiposity >90th centile remained a risk factor for cesarean delivery (p<0.0001). A fetal adiposity composite >90th centile was found to be more predictive of the need for unplanned cesarean delivery than an estimated fetal weight >90th centile (OR= 2.20 [95% CI: 1.65 – 2.94; p<0.001] vs. OR=1.74 [1.29 – 2.35, p<0.001]. Having a composite adiposity >90th centile was not found to be associated with an increased likelihood of operative vaginal delivery when compared with fetuses <90th centile (p=0.37). CONCLUSION: Fetuses with increased adipose deposition were more likely to require cesarean delivery. Given that increased fetal adiposity is a risk factor for cesarean delivery, consideration should be given to adding fetal thigh and abdominal wall thickness to fetal sonographic assessment in late pregnancy.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationHehir, M. P., Burke, N., Burke, G.,Turner, M., Breathnach, F. M., McAuliffe, F. M., Morrison, J. J., Dornan, S., Higgins, J., Cotter, A., Geary, M. P., McParland, P., Daly, S., Cody, F., Dicker, P., Tully, E. and Malone, F. D. (2019) 'Sonographic markers of increased fetal adiposity demonstrate an increased risk for Cesarean delivery', Ultrasound in Obstetrics and Gynecology. doi: 10.1002/uog.20263en
dc.identifier.doi10.1002/uog.20263en
dc.identifier.eissn1469-0705
dc.identifier.issn0960-7692
dc.identifier.journaltitleUltrasound in Obstetrics and Gynecologyen
dc.identifier.urihttps://hdl.handle.net/10468/7805
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc.en
dc.relation.urihttps://obgyn.onlinelibrary.wiley.com/doi/abs/10.1002/uog.20263
dc.rights© 2019, John Wiley & Sons Inc. This is the peer reviewed version of the following article: Hehir, M. P., Burke, N., Burke, G.,Turner, M., Breathnach, F. M., McAuliffe, F. M., Morrison, J. J., Dornan, S., Higgins, J., Cotter, A., Geary, M. P., McParland, P., Daly, S., Cody, F., Dicker, P., Tully, E. and Malone, F. D. (2019) 'Sonographic markers of increased fetal adiposity demonstrate an increased risk for Cesarean delivery', Ultrasound in Obstetrics and Gynecology. doi: 10.1002/uog.20263, which has been published in final form at https://doi.org/10.1002/uog.20263. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.en
dc.subjectAdiposityen
dc.subjectCesarean deliveryen
dc.subjectFetusen
dc.subjectSonographyen
dc.titleSonographic markers of increased fetal adiposity demonstrate an increased risk for Cesarean deliveryen
dc.typeArticle (peer-reviewed)en
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Hehir_et_al-2019-Ultrasound_in_Obstetrics_&_Gynecology_(1).pdf
Size:
690.73 KB
Format:
Adobe Portable Document Format
Description:
Accepted Version
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
2.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Obstetrics & Gynaecology - Journal articles