Shoulder dystocia and long-term endocrine morbidity of the offspring

Objective
Major metabolic risk factors for shoulder dystocia include maternal diabetes mellitus, obesity and excessive weight gain during pregnancy. In this study we evaluated whether infants who sustained shoulder dystocia at birth and thus were possibly exposed to a metabolically deranged pregnancy, are at an increased risk for long-term endocrine morbidity years thereafter.

Study Design
A population-based cohort analysis including deliveries between the years 1991 to 2014 in a tertiary referral hospital was conducted. Incidence of hospitalizations (up to age 18 years) due to endocrine morbidity was compared between offspring of deliveries complicated by shoulder dystocia and uncomplicated deliveries. A Kaplan-Meyer curve was used to assess cumulative hospitalization incidence.

Results
During the study period 242,342 deliveries met the inclusion criteria. Of those, 362 (0.14%) were complicated by shoulder dystocia. Comparable hospitalization rates due to various endocrinopathies was observed among infants of both groups (Table), as was the total endocrine-related hospitalization rate (0.6% vs. 0.5%; OR=1.16, 95% CI 0.29-4.68; p=0.692). Likewise, the Kaplan-Meier survival curve revealed no difference in the cumulative incidence of hospitalizations among offspring of both groups (log rank p-value=0.967; Figure).

Conclusion
In our population it seems that shoulder dystocia does not predict long-term pediatric endocrine morbidity.