Macrosomia ; risk factors and labor outcome

الملخص EN

This is a case-control comparative study carried out in Al-Basrah maternity & child hospital to estimate the frequency of macrosomic newborns among all deliveries conducted in the study period (November 2008-September 2009) to identify demographic, medical and obstetrical risk factors that carry risk of macrosomia as well as to assess labor and neonatal outcome.

All gravid women who delivered macrosomic newborns during the study period were included who constitute 208 cases.

This case group was compared to 250 gravid women who were selected among those who delivered newborns with birth weight of 3.000gms and more and less than 4.000 gms as control group.

Macrosomic newborns constitute 1.4 % of all deliveries.

Advanced maternal age, high parity and obesity were the main demographic risk factors.

Other factors which carry risk for macrosomia include previous macrosomic infant, prolonged gestation, maternal D.M and hypertension and male sex of newborn.

Macrosomic newborns were delivered more likely by cesarean section which was indicated commonly for cephalo-pelvic disproportion.

Those who delivered macrosomic newborns had significantly higher obstetrical complications in term of meconium stained liquor, prolonged labor, postpartum hemorrhage and genital tract injury.

Adverse neonatal outcome was reported among macrosomic newborns with significantly higher rate of stillbirth, shoulder dystocia and low apgar score.

In conclusion ; macrosomia still represent a significant problem with increased maternal morbidity, neonatal morbidity and mortality.