Macrosomic newborns: a 3-year review.

The objective of this study was to determine the incidence, perinatal complications and the outcome of macrosomic infants. A retrospective analysis was made of macrosomic deliveries and of those admitted into the Neonatology Unit. A control group of 854 deliveries weighing between 2500-4000 g was randomly composed. The incidence of macrosomic deliveries, stillbirth rates, sex, parity, maternal age, mode of delivery, perinatal complications like birth traumas, hypoglycemia, polycythemia, asphyxia, admission rate into the neonatal intensive care unit (NICU), and outcome were analyzed. Among a total of 11,827 deliveries, 829 (7%) were macrosomic neonates. Statistical analysis showed male predominance (p = 0.0001), a significant increase in cesarean section (p = 0.0001), and higher parity for the macrosomic group (p = 0.0001). The mothers of macrosomic newborns were older (p = 0.0001). The admission frequency of macrosomic deliveries into the NICU was almost two-fold. Birth injuries were found in 53 (6.4%) macrosomic infants, and macrosomic deliveries had a two-fold risk for birth injuries. Statistical analysis showed a significant difference between macrosomics and the control group for the frequency of birth traumas (p = 0.0007), hypoglycemia (p = 0.0001) and polycythemia (p = 0.0006). There were two deaths in macrosomic group versus one among control cases. Regarding the high birth trauma and NICU admission rates of macrosomic infants, it is important to emphasize the significance of prenatal diagnosis of fetal macrosomia and of management of these high-risk pregnancies in tertiary level hospitals.

Increasing low birth weight rates: deliveries in a tertiary hospital in istanbul.

OBJECTIVE: Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. METHODS: Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth weight and stillbirth deliveries were determined. FINDINGS: Among 19,533 total births, there were 450 (23.04 per 1000) stillbirths. Low birth weight rate was 10.61%. A significant increase in yearly distribution of low birth weight deliveries was observed (P<0.001). Very low birth weight and extremely low birth weight delivery rates were 3.14% and 1.58% respectively. Among 2073 low birth weight infants, 333 (16.06%) were stillbirths. The stillbirth delivery rate and the birth of a female infant among low birth weight deliveries were significantly higher than infants with birth weight ≥2500g (P<0.001, OR=28.37), (P<0.001) retrospectively. There was no statistical difference between low birth weight and maternal age. The rate of cesarean section among low birth weight infants was 49.4%. CONCLUSION: High low birth weight and stillbirth rates, as well as the increase in low birth weight deliveries over the past five years in this study are striking. For reduction of increased low birth weight rates, appropriate intervention methods should be initiated.