Outcomes of Fetal Macrosomia and Associated Factors: A Case-Control Facility Based Study ()
ABSTRACT
Objective: To identify risk factors of perinatal complications among macrosomic babies
in a third level health care facility. Method: We conducted a case-control
institutional based study. Cases (macrosomic babies and mothers with perinatal complications)
and controls (pairs free of perinatal
complication) of singleton
live births were
extracted from the maternity registry from January 2017 to December 2019. Matching
was done for sex and gestational age after exclusion of genetic cause of macrosomia.
The main primary outcome was the risk factors for complications. Logistic regression
was used to estimate the odds ratio and the magnitude of association between the
primary endpoint and the different covariates of the study. Results: Out of 362 couples included, we had 186
cases and 176 controls. The main perinatal
complications were the delivery by caesarean section (26.5%) and lesions of the
genital canal, 20.2%. There were no maternal deaths. Among newborns, metabolic complications
(19.6%) were a leading cause of harmful outcomes before respiratory complications
(12.4%), dystocic presentations (6.3%) or traumatic injuries (1.7%). The neonatal case fatality rate
was 2.8%. Maternal
age ≥30 years (p = 0.024); non-screening for gestational
diabetes (p = 0.027); history of caesarean
section (p = 0.041); weight gain ≥16 kg (p < 0.001); maternal HIV (p = 0.047); birth
weight ≥4500 g (p = 0.015) and birth height ≥52.7 ± 1.7 cm (p = 0.026) were
risk factors for perinatal
adverse outcomes. Conclusion: The delivery
of a macrosomic baby remains problematic in this setting, and emphasizes the need to improve routine screening
of gestational diabetes within a quality of prenatal follow-up through a multidisciplinary perinatal team involving obstetricians, endocrinologists
and neonatal pediatricians.
Share and Cite:
Nlend, A. , Gwodog, J. and Sandie, A. (2023) Outcomes of Fetal Macrosomia and Associated Factors: A Case-Control Facility Based Study.
Open Journal of Pediatrics,
13, 196-206. doi:
10.4236/ojped.2023.132025.
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