{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T03:25:58Z","timestamp":1761017158840},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,9,19]],"date-time":"2016-09-19T00:00:00Z","timestamp":1474243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>High birthweight is associated with complicated childbirth. The aim of the present study was to investigate the association between birthweight, mode of delivery, and neonatal complications among infants born at term with a birthweight \u22653000\u00a0g.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This population\u2010based cohort study used data from the Swedish Medical Birth Register from 1999 to 2012, including 1\u00a0030\u00a0775 births at &gt;36 completed weeks. Exposure was mode of delivery, categorized into non\u2010instrumental vaginal delivery (<jats:styled-content style=\"fixed-case\">VD<\/jats:styled-content>), emergency cesarean section (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>), vacuum extraction (<jats:styled-content style=\"fixed-case\">VE<\/jats:styled-content>) or cesarean section following attempted vacuum extraction (<jats:styled-content style=\"fixed-case\">VE<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>), and birthweight was divided into five categories (3000\u20133999\u00a0g, 4000\u20134499\u00a0g, 4500\u20134999\u00a0g, and \u22655000\u00a0g). The following outcomes were assessed: 5\u2010min Apgar score &lt;7, neonatal convulsions, intracranial hemorrhage, and brachial plexus injury. Infants born after <jats:styled-content style=\"fixed-case\">VD<\/jats:styled-content> with a birthweight of 3000\u20133999\u00a0g were used as reference in the logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The odds ratios for all complications increased at higher birthweights among infants born after <jats:styled-content style=\"fixed-case\">VE<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">VE<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">VD<\/jats:styled-content>. The highest risks were seen after <jats:styled-content style=\"fixed-case\">VE<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">VE<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> with an adjusted odds ratio for neonatal convulsions of 2.6 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.1\u20133.2) in the reference birthweight group and 6.3 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 4.3\u20139.2) among infants with a birthweight of \u22654500\u00a0g. The corresponding adjusted odds ratios for intracranial hemorrhage were 2.6 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.7\u20133.9) and 6.7 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.3\u201313.6) and for brachial plexus injury 4.0 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.3\u20134.9) and 88.4 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 71.9\u2013108.4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vacuum extraction is a risk factor for serious neonatal complications, in particular when used in macrosomic fetuses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12952","type":"journal-article","created":{"date-parts":[[2016,9,19]],"date-time":"2016-09-19T09:58:31Z","timestamp":1474279111000},"page":"1089-1096","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Vacuum extraction in fetal macrosomia and risk of neonatal complications: a population\u2010based cohort study"],"prefix":"10.1111","volume":"95","author":[{"given":"Katarina","family":"\u00c5berg","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Division of Reproductive Health Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"Norman","sequence":"additional","affiliation":[{"name":"Department of Clinical Science Intervention and Technology Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Department of Clinical Science Intervention and Technology Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Ek\u00e9us","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Division of Reproductive Health Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2000.079006440.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2006.143"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2009.01075.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000141442.59573.cd"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318278d014"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016341003686099"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0001-6349.2005.00632.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2973-y"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.12.005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2272-z"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.08.010"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000010239"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00005-C"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-008-0630-7"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.06.051"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.302"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.10.029"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.020"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-36"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2006.00119.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-1953-3"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2007.02.010"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03277.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00702.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01495.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1109185"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000601"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0656"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.05.073"},{"key":"e_1_2_9_31_1","unstructured":"K\u00e4ll\u00e9nB K\u00e4ll\u00e9nP.The Swedish Medical Birth Register \u2010 A summary of content and quality. 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