Risk Factors Associated with Shoulder Dystocia among Pregnant Women at Khon Kaen Hospital
Keywords:
shoulder dystocia, risk factors, pre-pregnancy body mass index, macrosomia, gestational diabetes mellitusAbstract
Shoulder dystocia is an unpredictable and often unavoidable obstetric emergency. Its cause is still unclear. The incidence of shoulder dystocia is not high but it can lead to severe maternal and neonatal complications. This analytical study using an unmatched case-control study, aimed to determine risk factors associated with shoulder dystocia (SD) among parturient women, Khon Kaen Hospital. Data were retrospectively collected from medical records of women who delivered between October1, 2010 and September 30, 2020. One hundred and sixty-three cases of SD and 326 cases of none SD were included in the study. Data were analyzed using descriptive statistics, simple logistic regression, and multiple logistics regression. The research identified statistically significant factors related to shoulder dystocia, comprising four factors: 1) pre-pregnancy body mass index (aOR = 3.94, 95% CI 1.34-11.58), 2) gestational diabetes (aOR = 5.37, 95% CI 1.58-28.23), 3) assisted vaginal delivery (aOR = 13.251, 95% CI 5.32-32.99), and 4) macrosomic infant (aOR = 49.33, 95% CI 6.19-392.79). It is recommended that nurse-midwives should encourage pregnant women or women who plan for pregnancy to control weight and eat a healthy diet to prevent obesity and diabetic mellitus during pregnancy. Furthermore, nurse-midwives should focus on screening and evaluating the size and weight of the fetus as they approach delivery to reduce the risk of shoulder dystocia.
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