Fetal macrosomia. Risk factors and outcome

ABSTRACT

To determine the risk factors predisposing to fetal macrosomia and assess the maternal and perinatal outcome in these patients. This was a retrospective analysis of all macrosomic deliveries in the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Sultanate of Oman, during a 3-year period from January 2001 - December 2003. The maternal and neonatal records of infants with birth weight of >/= 4000 g [n=275] were reviewed. Outcome variables included demographic profile, antenatal risk factors, mode of delivery and maternal and perinatal complications. A total of 7367 deliveries occurred during the study period. The rate of macrosomic deliveries was 3.75% and the rate of deliveries >/= 4500 g was 0.48%. The mean birth weight of the study group was 4230 +/- 220 g. Obesity, diabetes, prolonged gestation and postpartum hemorrhage were significantly higher in the study group. The cesarean section rate was 25.8% for the study group compared to the general incidence of 13.1% during the study period [p<0.0001]. The incidence of shoulder dystocia was 7.6% compared to the general incidence of 0.48% during the study period [p<0.0001]. There were 7 cases of Erb's palsy, all except one recovered without sequelae by 3 months of age. Gestational diabetes, maternal obesity, increasing age and parity were the main risk factors for fetal macrosomia. The incidence of shoulder dystocia, birth injuries and neonatal morbidity increased in this group