Incidence, Risk Factors and Obstetrics Complications Associated with Macrosomic Births in Al-Yarmouk Teaching Hospital Over One Year
Background: Macrosomic fetus (large fetus) is associated with increase maternal and
fetal complications during delivery and it will affect the mode of delivery.
Objective: To determine the incidence, risk factors associated with macrosomic baby and
quantify its obstetrics complications.
Methods: A retrospective case control study, carried out at Al-Yarmouk Teaching
Hospital, Department of Obstetrics and Gynecology from the 1st of March 2010 to the 28th
of February 2011.
The study is based on a comparison of maternal data in (306) women with macrosomic
baby (BW > 4000 gm) and (300) women with normal birth weight babies (BW 2500 to less
than 40000 gm). Analysis included information on potential risk factors for high birth
weight infant: maternal age, parity, maternal anthropometrics indexes, previous delivery of
macrosomic baby, antenatal care, past medical disease, level of education, smoking,
infant sex and gestational age. During labour observation of prolonged labour, emergency
cesarean section, shoulder dystocia, perineal laceration, postpartum hemorrhage, blood
transfusion, postpartum infection and prolonged hospital stay.
Results: The incidence of macrosomic baby in Al-Yarmouk Teaching Hospital over one
year was 2.4 %. There was a significantly increased risk of macrosomia in high BMI and
maternal age =>35 years (P=0.0001). Mother whose parity 4 or more (P=0.0001) and
those with previous macrosomic birth (P=0.0001) were also significant. Macrosomic infant
was more likely male (P=0.0001) and post term (P=0.0001). Diabetes mellitus also show
increase risk of macrosomia (P=0.0001) prenatal care and mother education show
adverse outcome with fetal macrosomia. Smoking during pregnancy was associated with
a significantly decrease risk of macrosomia (P=0.006). Cesarean section rate in
macrosomic group was 48% versus 32.3% in control group (P=0.0001). Shoulder dystocia
9.5% in macrosomic group while no case in control group, also increase PPH (P=0.000),
blood transfusion (P=0.0001), postpartum infection (P=0.003) also increase perineal
laceration 3rd and 4th degree significantly (P=0.0001) and days of hospital stay
Conclusion: Macrosomia is more common in mothers who are obese, multiparous, with
previous history of macrosomic birth and non smoker and more common in male fetus and
post term. Macosomia is associated with significant obstetrics complications.
Keywords: Macrosomia, Fetal complications.
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