Maternal weight and fetal injury at birth: data deriving from medico-legal research.

The relationships among maternal weight, gestational weight gain, fetal birth weight and birth injuries have been investigated in connection with 62 cases of shoulder dystocia that involved permanent impairment of the newborn or neonatal demise. A high prevalence of > 13.5 kgs. gestational weight increase between the first and last office visits (62%) obesity expressed as > or = 87 kg. body weight at term (64.1%) and > or = 4000 gm. birth weight (80%) was found in this group of patients. The results indicate that the relationship between excessive maternal and fetal body weights and shoulder dystocia related fetal or neonatal impairment is closer than previous studies have suggested. These results underline the importance of appropriate and intensive nutritional counselling of the mother throughout pregnancy, noting that arrest of the shoulders is only one of those obstetric complications that are closely related to maternal obesity. The findings underline the usefulness of medico-legal reviews in clinical research.