Could Delivering Big Babies Earlier Help Reduce Risk of Injuries?
Babies are born at many different sizes. While the average weight of a newborn is 7.7 pounds, many babies are a little bit heavier than that. If a baby weighs more than 8 pounds, 7 ounces, the baby is considered macrosomic, meaning it is much larger than average. While many macrosomic babies go on to become healthy children and adults, the larger size of the child at birth can increase the risk of some types of birth injuries and complications.
Shoulder dystocia is a condition in which the child’s shoulders get stuck behind the mother’s pelvic bone during delivery. In births involving babies of a normal weight, shoulder dystocia only occurs in about 1 percent of births. But in births involving babies that are larger than average, shoulder dystocia becomes much more common, happening in about 10 percent of births.
When shoulder dystocia occurs, it can result in injuries to the child such as broken or fractured bones, nerve damage, Klumpke’s palsy, or Erb’s palsy. Larger babies may also experience a lack of oxygen during delivery. In addition to the risk of injuries to the child, the mother may also experience tearing or bleeding while trying to deliver a large baby.
If a doctor realizes an infant is likely large enough to be at risk for complications during delivery, they might suggest is scheduling a C-section. But could inducing labor early for large babies possibly help reduce the risk of birth injuries? That’s what some researchers in the United Kingdom are looking into.
In a partnership between the University of Warwick, the University Hospitals Coventry and Warwickshire NHS Trust, and the Perinatal Institute, researchers are conducting a study of 4,000 pregnancies in England where the baby is believed to be larger than average. The mothers participating in the study will randomly be divided into two groups: one where labor is induced at about 38 weeks and another where labor will begin naturally.
The trial is expected to carry on for over three and a half years and will help provide additional data in regards to which method is safest for delivering large babies. Professor Jason Gardosi of the Perinatal Institute stated, “Many clinicians in our UK-wide network of obstetricians and midwives are often at a loss of what to advise the mother, as the evidence is not clear, and can be interpreted in different ways.”
This isn’t the first study to look into whether or not inducing labor to deliver large babies early is a safe option. In 2015, another study was conducted in Belgium, France, and Switzerland which found that one case of shoulder dystocia was prevented for every 25 labor inductions. However, the authors of the study also acknowledged their study had some limitations because they had a smaller study group than they originally anticipated. Since induced labor also has its own risks, this study suggested that there would be a balancing act between using induction at the 37-38 week mark and to prevent injuries and avoiding deliveries before 39 weeks that could also put babies at risk for injuries.