Labour risk for bigger babies

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The Independent Online
BIG BABIES are 40 per cent more likely to die during labour than normal weight babies because medical staff are not properly trained to deal with difficult deliveries, it was revealed yesterday.

The findings have caused concern among health professionals as more women are giving birth to larger babies. Since 1982, the number of babies born weighing over 4kg or 8.8lb has increased from 8.5 per cent of all births to 10.8 per cent in 1996. There are between 650,000 and 700,000 live births every year.

The study was carried out by the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI), which was formed in 1992 to find ways of preventing infant mortality.

"Large babies have an increased frequency of difficult deliveries, foetal distress, large shoulders and diabetes in the mother," said Dr Mary Macintosh, director of CESDI and a consultant obstetrician atHomerton Hospital, London. "In the cases of deaths, it was often found that the size of the baby was disregarded when sorting out the birth plan and care for the mother."

Foetal surveillance was one of the commonest problems, with staff not recording that the baby was large or understanding that size could be a problem.

Although it was found that large babies had less chance of dying overall, they were more likely to die during labour with 0.7 babies per 1,000 births dying during labour compared with 0.5 smaller babies.

The report found that inadequate record-keeping led to poor communication between different medical staff about a patient's state. Delivery delays and the lack of an experienced paediatrician being on hand led to more deaths than were necessary. Better training could save 130 babies a year.