SynthesisFrontiers in global women's health2026
Maternal and neonatal outcomes among women with suspected macrosomia undergoing induction of labor: a systematic review and meta-analysis.
Synthesis in Frontiers in global women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
Background: Fetal macrosomia, defined as birth weight ≥4,000 g, complicates 1%-10% of pregnancies and is associated with adverse maternal and neonatal outcomes including cesarean section, shoulder dystocia, and brachial plexus injury. The optimal management of suspected macrosomia induction of labor vs. expectant management remains controversial, with no standardized international guidelines. Objective: To comprehensively evaluate maternal and neonatal outcomes among women with suspected fetal macrosomia undergoing induction of labor compared with expectant management. Methods: We systematically searched MEDLINE, CINAHL, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to December 2023. Randomized controlled trials and observational studies comparing induction of labor vs. expectant management in pregnancies with suspected fetal macrosomia were included. Primary outcomes were cesarean section, shoulder dystocia, Apgar score <7 at 5 min, and brachial plexus palsy. Pooled risk ratios with 95% confidence intervals were calculated using random-effects models. Subgroup analysis by study design and sensitivity analyses were performed. Risk of bias was assessed using the Cochrane tool for RCTs and the Newcastle-Ottawa Scale for observational studies. Results: Thirteen studies (4 RCTs, 9 observational; Conclusion: Induction of labor for suspected fetal macrosomia does not significantly increase or decrease the risk of cesarean section or shoulder dystocia compared with expectant management. However, induction may improve neonatal outcomes as measured by Apgar scores, though this finding is driven by RCT evidence. The discrepancy between RCT and observational findings underscores the need for larger, well-designed trials to inform clinical guidelines. Clinicians should engage in shared decision-making, considering patient preferences and clinical context when managing suspected fetal macrosomia. Systematic Review Registration: https://osf.io/bkrc5.
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