PREVALENCE AND OUTCOME OF THE MACROSOMIC INFANTS

Abstract

The birth weight is one of the important factors affecting the perinatal morbidity and mortality. Fetal macrosomia is associated with increased risks of cesarean section and trauma. To determine prevalence and outcome of the macrosomic infants, this case-control, prospective study is performed in the two university hospitals in Tehran during a 36- month period between 2002 through 2004. 1000 neonates with birth weight of at least 4000g (<90th centile) constituted the case group. Another 2000 Cases amongst the newborns delivered in the same period between 2500 and 3999g (10th-90th centile) formed the control group. A total of 17236 deliveries occurred during the study period. The prevalence of macrosomic deliveries was 5.8 and prevalence of the deliveries (>4500g or heavier) was 0.84%. The mean birth weight of study group was 4254215 and 3245310g of control group (P<0.001).While the cesarean section rate was 35.2% for study group and it was 18.5% for the control group (P<0.001) in the study group. 16 cases of clavicular fracture (1.6%), 13 cases of brachial plexus palsy (1.3%), (p<0.001). No perinatal mortality was recorded in two groups. There were 12 cases (1.2%) of asphyxia related to delivery in the study group (p<0.01). The rate of maternal complication, were significantly higher in the study group (p<0.01). The macrosomic infants are in increased risk for birth trauma and asphyxia. The risk of birth trauma for the infants weighing 4500g or more is even greater. The majority of factors which lead to the delivery of macrosomic infants are preventable.