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Table of Contents
Vol. 90, No. 2, 2006
Issue release date: August 2006
Biol Neonate 2006;90:98–103
(DOI:10.1159/000092042)

Fetal Macrosomia – A Continuing Obstetric Challenge

Heiskanen N. · Raatikainen K. · Heinonen S.
Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland

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Abstract

Background: Macrosomic fetuses represent a continuing challenge in obstetrics. Objectives: We studied maternal risk factors of fetal macrosomia and maternal and infant outcome in such cases. Methods: A retrospective cohort study was carried out with a total of 26,961 singleton pregnancies between 1989 and 2001. Records of 886 mothers who gave birth to live born infants weighing ≧4,500 g were compared to those of 26,075 mothers with normal weight (<4,500 g) infants. Multiple regression analysis was used to identify independent reproductive risk factors. Perinatal complications were also assessed. Results: The incidence of fetal macrosomia was 3.4%. Diabetes, previous macrosomic birth, postdatism (>42 weeks of gestation), obesity (BMI > 25 before pregnancy), male infant, gestational diabetes mellitus, and non-smoking were independent risk factors of fetal macrosomia, with adjusted risks of 4.6, 3.1, 3.1, 2.0, 1.9, 1.6, 1.4, respectively. In the macrosomic group, birth and maternal traumas occurred significantly more often than in the control group. However, records of subsequent pregnancies (n = 250) after the study period showed that a previous uncomplicated birth appeared to decrease complication risks. Conclusions: Most cases of fetal macrosomia occur in low-risk pregnancies and evaluation of maternal risks cannot accurately predict which women will eventually give birth to an overweight newborn. After an uncomplicated birth of a macrosomic infant, vaginal delivery may be a safe option for the infant and mother.



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References

  1. Arbuckle TE, Sherman GJ: An analysis of birth weight by gestational age in Canada. Can Med Assoc J 1989;140:157–165.
  2. Oja H, Koiranen M, Rantakallio P: Fitting mixture models to birth weight data: a case study. Biometrics 1991;47:883–897.
  3. Power C: National trends in birth weight: implications for future adult disease. BMJ 1994;308:1270–1271.
  4. Wikström I, Axelsson O, Bergström R, Meirik O: Traumatic injury in large-for-date-infants. Acta Obstet Gynecol Scand 1988;67:259–264.
  5. Lipscomb KR, Gregory K, Shaw K: The outcome of macrosomic infants weighing at least 4500 grams: Los Angeles County + University of Southern California experience. Obstet Gynecol 1995;85:558–564.
  6. Grassi AE, Giuliano MA: The neonate with macrosomia. Clin Obstet Gynecol 2000;43:335–339.
  7. Ventura SJ, Martin JA, Curtin SC, Mathews TJ, Park MM: Births: Final data from 1998. Natl Vital Stat Rep 2000;48:1–100.

    External Resources

  8. Langer O: Fetal macrosomia. Etiologic factors. Clin Obstet Gynecol 2000;43:283–297.
  9. Ferber A: Maternal complications of fetal macrosomia. Clin Obstet Gynecol 2000;43:335–359.
  10. Sacks DA, Chen W: Estimating fetal weight in the management of macrosomia. Obstet Gynecol Surv 2000;55:229–239.
  11. Mocanu EV, Greene RA, Byrne BM, Turner MJ: Obstetric and neonatal outcome of babies weighing more than 4.5 kg: an analysis by parity. Eur J Obstet Gynecol Reprod Biol 2000;92:229–233.
  12. Kramer MS, Morin I, Yang H, Platt RW, Usher R, McNamara H, Joseph KS, Wen SW: Why are babies getting bigger? Temporal trends in fetal growth and its determinants. J Pediatr 2002;141:538–542.
  13. Wollschlaeger K, Nieder J, Köppe I, Härtlein K: A study of fetal macrosomia. Arch Gynecol Obstet 1999;263:51–55.
  14. Spellacy WN, Miller S, Winegar A, Peterson PQ: Macrosomia-maternal characteristics and infant complications. Obstet Gynecol 1985;66:158–161.
  15. Lim JH, Tan BC, Jammal AE, Symonds EM: Delivery of macrosomic babies: management and outcomes of 330 cases. J Obstet Gynaecol 2002;22:370–374.
  16. Boulet SL, Alexander GR, Salihu HM, Pass MA: Macrosomic births in the United States: determinants, outcomes, and proposed grades of risk. Am J Obstet Gynecol 2003;188:1372–1378.
  17. Meshari AA, DeSilva S, Rahman I: Fetal macrosomia: maternal risks and fetal outcome. Int J Gynecol Obstet 1990;32:215–222.
  18. Bricker L, Neilson JP: Routine ultrasound in late pregnancy (after 24 weeks gestation). The Cochrane Database of Systematic Reviews 2000, Issue 1. Art. No.: CD001451. DOI: 10.1002/14651858.CD001451.


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