{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T14:50:29Z","timestamp":1781707829736,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Shoulder dystocia is a rare obstetric complication, and the risk of recurrence is important for planning future deliveries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>The objectives of our study were to estimate the incidence and risk factors for recurrence of shoulder dystocia and to identify women at high risk of recurrence in a subsequent vaginal delivery. The study design was a nationwide register\u2010based study including data from the Danish Medical Birth Registry and National Patient Register in the period 2007\u20132017. Nulliparous women with a singleton fetus in cephalic presentation were included for analysis of risk factors in index and subsequent delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 6002 cases of shoulder dystocia were reported with an overall incidence among women with vaginal delivery of 1.2%. Among 222\u2009225 nulliparous women with vaginal births, shoulder dystocia complicated 2209 (1.0%) deliveries. A subsequent birth was registered in 1106 (50.1%) of the women with shoulder dystocia in index delivery of which 837 (77.8%) delivered vaginally. Recurrence of shoulder dystocia was reported in 60 (7.2%) with a six\u2010fold increased risk compared with women without a prior history of shoulder dystocia (risk ratio [RR] 5.70, 95% confidence interval [CI]: 4.41 to 7.38; adjusted RR 3.06, 95% CI: 2.03 to 4.68). Low maternal height was a significant risk factor for recurrence of shoulder dystocia. In the subsequent delivery, significant risk factors for recurrence were birthweight &gt;4000\u2009g, positive fetal weight difference exceeding 250\u2009g from index to subsequent delivery, stimulation with oxytocin and operative vaginal delivery. In the subsequent pregnancy following shoulder dystocia, women who underwent a planned cesarean (<jats:italic>n<\/jats:italic>\u2009=\u2009176) were characterized by more advanced age and a higher prevalence of diabetes in the subsequent pregnancy. Furthermore, they had more often experienced operative vaginal delivery, severe perineal lacerations, and severe neonatal complications at the index delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of shoulder dystocia among nulliparous women with vaginal delivery was 1.0% with a 7.2% risk of recurrence in a population where about 50% had a subsequent birth and of these 78% had subsequent vaginal delivery. Important risk factors for recurrence were low maternal height, increase of birthweight \u2265250\u2009g from index to subsequent delivery and operative vaginal delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14784","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T06:44:37Z","timestamp":1709016277000},"page":"1975-1984","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Incidence of shoulder dystocia and risk factors for recurrence in the subsequent pregnancy\u2014A historical register\u2010based cohort study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-2783","authenticated-orcid":false,"given":"Maria","family":"Jeppegaard","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Copenhagen University Hospital\u2014Holbaek  Holbaek Denmark"},{"name":"Department of Gynecology and Obstetrics Copenhagen University Hospital\u2014Amager and Hvidovre  Hvidovre Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie H.","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Surgery Zealand University Hospital  K\u00f8ge Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalie B.","family":"Thams","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalie B.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Copenhagen University, Hospital\u2014Zealand University Hospital Roskilde  Roskilde 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