Risk factors of fetal macrosomia: role of maternal nurition

To assess the effect of maternal diet during pregnancy on the risk of delivering a large for gestational baby [macrosome]. A food intake survey of 350 healthy pregnant Tunisian women, 52 in group macrosomia and 298 in group control. Only term [37 completed Weeks of gestation] infants were included. All women in the study group completed food frequency questionnaires on their diet in the last 24 hours before delivery. Frequency of foctal macrosomia was 15.8%[n=52]. Pregravid maternal BMI>30[OR=3,06[1,51-6,17]], prolonged term of pregnancy[>41weeks of gestation] [OR=2,49[1, 04-5,88]] and the antecedent of a macrosomic delivery [OR=6,53[2,89-14,74]] were significantly associated with the risk of fetal macrosomia. The mean daily total energetic intakes, protein intakes and carbohydrate intakes were significantly higher in the macrosomia group than in the control group. However, with multivariate analysis after adjustment for term and Pregravid BMI, no significant correlation was found between nutrient intakes and risk of fetal macrosomia. Maternal food intakes in the end of pregnancy are not a significant determinant of fetal macrosomia compared to maternal BMI, and term of pregnancy

Prevalence and risk factors of cesarean section in a population of Tunisian diabetic pregnant women

To determine the rate of and indication of cesarean section among women with preexisting and gestational diabetes mellitus compared with glucose-tolerant women. From case-control study of 400 Tunisian pregnant women [200 in group diabetes and 200 in group control] seen over a 5-year period for medical management, women who had a cesarean section were identified and the reason for the section determined from a review of the medical record. A control group of women who had a section were obtained from an existing data-base of glucose-tolerant women Women in group diabetes were significantly more aged, with higher BMI and birth weight than in control group [p<0, 05]. Global cesarean rate was significantly higher in diabetes group [50, 2%] than in control group [28, 2%] [OR=2, 72 IC[1, 76-4, 20]]. Rate of elective cesarean delivery was significantly higher in diabetes group [40, 5%] than in control group [8, 5%] [OR=4, 87 [2, 69-8, 90]]. However, vaginal delivery success rate when trial of labour was tried was similar in study groups [76%and 78%]. Most frequent indications for cesarean delivery in diabetes group were foetal macrosomia and scared uterus. Multivariate analysis showed that maternal obesity, unbalanced diabetes, unplanned pregnancy, and foetal macrosomia were significantly correlated to risk of cesarean delivery in diabetic women. Cesarean rate in our population of diabetic. pregnant women is higher than in group control. Maternal-obesity, unbalanced diabetes, unplanned pregnanc1, and foetal macrosomia were significantly correlated to risk of cesarean delivery in diabetic women