Macrosomia: Prevalence and predisposing factors as seen at a university teaching hospital, South-South Nigeria

Abstract

Background: The rising prevalence and the attendant morbidity and mortality arising from macrosomic births require a good understanding and good management protocol.

Objective: To determine the prevalence and associated factors of macrosomia.

Design: Retrospective study

Setting: The labor ward, isolation ward and main theatre of the University of PortHarcourt Teaching Hospital (UPTH). Subjects: Four hundred and sixty babies with macrosomia delivered at UPTH. Patients and Method: Data including the birth weight, gestational age, sex, and mode of delivery, Apgar score, morbidity in the newborn, duration of admission, outcome of management, maternal age, parity, pregnancy and labor complications relating to the subjects were extracted and analyzed.

Results: The prevalence of macrosomia was 7.4% (490/6642). It was  highest in multiparous parturients (77.8%) (358/460) aged 30-34 years (42%) (193/460). Significantly more males 302(65.7%) (302/460) than females 158(34.3%) (158/460) were macrosomic p<0.001. Ninety five (20.6%) (95/460) had moderate to severe birth asphyxia while 2% (9/460) were still births. Among the pregnancy and labor complications respectively noted in the parturients, gestational diabetes mellitus (18.2%) (28/154) and cephalopelvic disproportion (43%) were the most frequent. Majority, 299 (65.2%) (299/460) had spontaneous vertex delivery, while 150 (32.6%) (150/460) were delivered by Caesarean section. Birth asphyxia (20.6%) (95/460) and prematurity (8.5%) (39/460) were the leading fetal complications.

Conclusion: Multiparous expectant women aged 30-34 years and those with gestational diabetes mellitus are prone to delivering macrosomic babies in this community. They should therefore be properly supervised with the fetus monitored for growth and size and appropriate mode of delivery and neonatal resuscitation determined prenatally to reduce the incidence of adverse perinatal outcome.

Key words: Macrosomia, Predisposing factors, Prevalence