Maternal and Child Health Journal

, Volume 19, Issue 12, pp 2578–2586

Labor and Delivery Experiences of Mothers with Suspected Large Babies

  • Erika R. Cheng
  • Eugene R. Declercq
  • Candice Belanoff
  • Naomi E. Stotland
  • Ronald E. Iverson

DOI: 10.1007/s10995-015-1776-0

Cite this article as:
Cheng, E.R., Declercq, E.R., Belanoff, C. et al. Matern Child Health J (2015) 19: 2578. doi:10.1007/s10995-015-1776-0



To characterize the prevalence of and factors associated with clinicians’ prenatal suspicion of a large baby; and to determine whether communicating fetal size concerns to patients was associated with labor and delivery interventions and outcomes.


We examined data from women without a prior cesarean who responded to Listening to Mothers III, a nationally representative survey of women who had given birth between July 2011 and June 2012 (n = 1960). We estimated the effect of having a suspected large baby (SLB) on the odds of six labor and delivery outcomes.


Nearly one-third (31.2 %) of women were told by their maternity care providers that their babies might be getting “quite large”; however, only 9.9 % delivered a baby weighing ≥4000 g (19.7 % among mothers with SLBs, 5.5 % without). Women with SLBs had increased adjusted odds of medically-induced labor (AOR 1.9; 95 % CI 1.4–2.6), attempted self-induced labor (AOR 1.9; 95 % CI 1.4–2.7), and use of epidural analgesics (AOR 2.0; 95 % CI 1.4–2.9). No differences were noted for overall cesarean rates, although women with SLBs were more likely to ask for (AOR 4.6; 95 % CI 2.8–7.6) and have planned (AOR 1.8; 95 % CI 1.0–4.5) cesarean deliveries. These associations were not affected by adjustment for gestational age and birthweight.

Conclusions for Practice

Only one in five US women who were told that their babies might be getting quite large actually delivered infants weighing ≥4000 g. However, the suspicion of a large baby was associated with an increase in perinatal interventions, regardless of actual fetal size.


Suspected macrosomia Mode of delivery Labor induction 

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Erika R. Cheng
    • 1
  • Eugene R. Declercq
    • 2
  • Candice Belanoff
    • 3
  • Naomi E. Stotland
    • 4
  • Ronald E. Iverson
    • 5
  1. 1.Division of General Academic PediatricsHarvard Medical School and Massachusetts General Hospital for ChildrenBostonUSA
  2. 2.Department of Community Health SciencesBoston University School of Public HealthBostonUSA
  3. 3.Department of Community Health SciencesBoston University School of Public HealthBostonUSA
  4. 4.Department of Obstetrics, Gynecology, and Reproductive ScienceSan Francisco General Hospital, University of California, San FranciscoSan FranciscoUSA
  5. 5.Department of Obstetrics and GynecologyBoston University School of MedicineEast BostonUSA

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