ABSTRACT Objective: To identify the impact of an abnormally large neonatal chest circumference relative to head circumference on labor and neonatal morbidity. Methods: We used a retrospective cohort design to study 54 obstetric cases in which the neonatal thoracic circumference was ≥2.5 cm greater than that of the head. For each case we sought controls with a smaller thorax-head circumference difference. Ninety-seven controls were matched with their respective cases for birth weight, parity, maternal body mass index (BMI), and maternal ethnicity. Results: Cases had significantly smaller heads and larger trunks than controls (P < 0.0001). Cases were twice as likely (39% vs 19%, P = 0.007) to require admission to the neonatal intensive care unit. There was no significant difference between cases and controls in the frequency of shoulder dystocia, long second stage, or long deceleration phase of labor. However, compound presentations occurred more frequently in the cases than in controls (5.5% vs 0%, P = 0.044). Conclusion: Babies with disproportionately large trunk growth were at risk for requiring neonatal intensive care and for compound presentation.
Cite this paper
L. Cavalieri, R. , Laroche, S. and R. Cohen, W. (2012) Perinatal consequences of disproportionate fetal trunk growth. Open Journal of Obstetrics and Gynecology, 2, 131-135. doi: 10.4236/ojog.2012.22025.
 Catalano, P.M., Thomas, A., Huston-Presley, L. and Amini, S.B. (2003) Increased fetal adiposity: A very sensitive marker of abnormal in utero development. American Journal of Obstetrics & Gynecology, 189, 1698-1704.
 Catalano, P.M., Drago, N.M. and Saeid, B.A. (1995) Factors affecting fetal growth and body composition. American Journal of Obstetrics & Gynecology, 172, 1459-1463.
 Catalano, P.M., Thomas, A.J., Avallone, D.A. and Amini S.B. (1995) Anthropometric estimation of neonatal body composition. American Journal of Obstetrics & Gynecology, 173, 1176-1181.
 Weizsaecker, K., Deaver, J.E. and Cohen, W.R. (2007) Labour characteristics and neonatal Erb’s palsy. British Journal of Obstetrics and Gynaecology, 114, 1003-1009.
 Bahar, A.M. (1996) Risk factors and fetal outcome in cases of shoulder dystocia compared with normal deliveries of similar birthweight. British Journal of Obstetrics and Gynaecology, 103, 868-872.
 Miller, R.S., Devine, P.C. and Johnson, E.B. (2007) Sonographic fetal asymmetry predicts shoulder dystocia. Journal of Ultrasound in Medicine, 26, 1523-1528.
 Elliott, J.P., Garite, T.J., Freeman, R.K., McQuown, D.S. and Patel, J.M. (1982) Ultrasonic prediction of fetal macrosomia in diabetic patients. Obstetrics & Gynecology, 60, 159-162.
 Cohen, B.F., Penning, S., Ansley, D., Porto, M. and Garite, T. (1999) The incidence and severity of shoulder dystocia correlates with a sonographic measurement of asymmetry in patients with diabetes. American Journal of Perinatology, 16, 197-201. doi:10.1055/s-2007-993858
 Cohen, B., Penning, S., Major, C., Ansley, D., Porto, M. and Garite, T. (1996) Sonographic prediction of shoulder dystocia in infants of diabetic mothers. Obstetrics & Gynecology, 88, 10-13. doi:10.1016/0029-7844(96)00067-1
 Modanlou, H.D., Komatsu, G., Dorchester, W., Freeman, R.K. and Bosu, S.K. (1982) Large-for-gestational-age neonates: Anthropometric reasons for shoulder dystocia. Obstetrics & Gynecology, 60, 417-423.
 Hopwood, H.G. (1982) Shoulder dystocia: Fifteen years’ experience in a community hospital. American Journal of Obstetrics & Gynecology, 144, 162-166.
 Gross, T.L., Sokol, R.J., Williams, T. and Thompson, K. (1987) Shoulder dystocia: A fetal-physician risk. American Journal of Obstetrics & Gynecology, 156, 1408-1418.
 Friedman, E.A. (1978) Labor: Clinical evaluation and management. 2nd Edition, Appleton Century Crofts, New York.
 McFarland, M.B., Trylovich, C.G. and Langer, O. (1998) Anthropometric differences in macrosomic infants of diabetic and nondiabetic mothers. Journal of Maternal-Fetal Medicine, 7, 292-295.
 Koo, W.W.K., Walters, J.C. and Hockman, E.M. (2004) Body composition in neonates: Relationship between measured and derived anthropometry with dual-energy x-ray absorptiometry measurements. Pediatric Research, 56, 694-700. doi:10.1203/01.PDR.0000142587.59238.BD
 Salim, R., Hasanein, J., Nachum, Z. and Shalev, E. (2004) Anthropometric parameters in infants of gestational diabetic women with strict glycemic control. American Journal of Obstetrics & Gynecology, 104, 1021-1024.