Title: [Maternal and perinatal factors related to fetal macrosomia]

POPLINE Document Number: 314986

Author(s):

Madi JM
Rombaldi RL
de Oliveira Filho PF
de Araujo BF
Zatti H

Source citation:

Revista Brasileira de Ginecologia e Obstetricia, 2006 Apr;28(4):232-237.

Abstract:

The purpose was to identify maternal and perinatal factors related to neonates with birthweight >/=4,000 g. Cross-section cohort study with 411 consecutive cases of fetal macrosomia (FM) which occurred from March 1998 to March 2005. Data were compared to 7,349 cases of fetal birthweight >/=2,500 and < 3,999 g which occurred in the same period. Maternal variables (maternal age, parity, diabetes, previous cesarean section, meconium-stained amniotic fluid, cephalopelvic disproportion, main cesarean section indications) and perinatal variables (birth injury,<71-min and 5-min Apgar score, fetal and early neonatal mortality range, need of neonatal intensive care unit) were analyzed. For statistical analysis the x/² test with Yates correction and Student's t test were used with the level of significance set at 5%. FM was significantly associated with older mothers, more parous and <71-min Apgar score (p<0.05; OR=1.8; 95% CI: 1,4-2.5) and <75-min Apgar score (p<0,05; OR=2.3; 95% CI: 1.3-4,1), diabetes mellitus (p<0.05; OR=4.2; 95% CI: 2.7-6.4), meconium-stained amniotic fluid (p<0.02; OR=1.3; 95% CI: 1.0-1.7), need of neonatal intensive care unit (p<0,05; OR=2.0; 95% CI: 1.5-2.7), early neonatal mortality (p<0,05; OR= 2.7; 95% CI: 1.0-6.7), cesarean section (p< 0.05; OR= 2.03; 95% CI: 1,6-2,5) and cephalopelvic disproportion (p< 0.05;OR= 2.8; 95% CI: 1.6-4,8). There was nostatistical difference between birth injury and fetal mortality range. In the FM group the main cesarean section indications were repeat cesarean sections (11.9%) and cephalopelvic disproportion (8.6%); in the normal birthweight group, repeat cesareans (8.3%) and fetal distress during labor (3.9%). In spite of the characteristic limitations of a retrospective evaluation, the analysis demonstrated which complications were associated with large fetal size, being useful in obstetric handling of patients with a diagnosis of extreme fetal growth. FM remains an obstetric problem of difficult solution, associated with important maternal and perinatal health problems, due to the significant observed rates of maternal and perinatal morbidity and mortality in developed and developing countries. (author's)

Keywords:

Research Report
Cross Sectional Analysis
Pregnant Women
Fetus
Infant
Birth Weight
Maternal Age
Multiparity
Cesarean Section
Pregnancy Complications
Neonatal Diseases and Abnormalities
Research Methodology
Population Characteristics
Demographic Factors
Population
Pregnancy
Reproduction
Youth
Age Factors
Body Weight
Physiology
Biology
Parental Age
Parity
Fertility Measurements
Fertility
Population Dynamics
Obstetrical Surgery
Surgery
Treatment
Medical Procedures
Medicine
Health Services
Delivery of Health Care
Health
Diseases