Fetal macrosomia at 4500 gm: prevalence and determinants

Foetal macrosomia with a weight higher than 4500g, is observed in approximately 1.5% of pregnancies at term. It is a high-risk condition for mother and infant with an important morbidity and mortality risk. The objective of our retrospective and comparative study [1999-2002] was to evaluate the prevalence of foetal macrosomia [birth weight >/= 4500 g] and to describe the maternal characteristics in pregnancies with foetal macrosomia. All births with a weight >/= 4500g [n°:321] were compared with two control groups, the first with a birth weight between 4000 and 4500g [n°: 240] and the second with a birth weight between 3500 to 4000g [n°: 241]. On our total of 12835 newborns, we had 2.9% with a birth weight >/= 4500g. The comparative study showed that the determining factors macrosomia were a maternal age of >/= 36 year, a parity of >/= 4, a maternal weight of >/= 90kg, a history of gestational family or macrosomia and history of diabetes mellitus in the family

Prevalence and risk factors of fetal macrosomia in diabetic women in Tunisian center

The objective of our study was to evaluate the frequency and the risk factors for fatal macrosomia in a population of Tunisian diabetic pregnant women. During five years, 400 pregnant women entered our case-control study, including 200 with diabetes and 200 as a control group. These pregnant women had a single foetus and were at term. The diabetes group was composed of 143 women with gestational diabetes and 57 women with pregravid diabetes. The women with diabetes were significantly older, multiparous and with a more elevated BMI than the women in the control group [p <0.01]. The risk of foetal macrosomia was significantly more associated with a BMI of > 30 [OR = 1.29], a poor diabetic control during pregnancy [OR = 9.41] and previous antecedent foetal macrosomia [OR = 7.93]. However, multivariate analysis after the control for confounding factors [BMI, term, and parity], limited the significantly increased risk for foetal macrosomia to the number of consultations and the insulin doses used in the third trimester of the pregnancy