Pregnancy Characteristics of Macrosomic Birth

Abstract

Pregnancy Characteristics of Macrosomic Birth

Waralak      Yamasmit   MD

Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Objective: To determine the pregnancy characteristics of macrosomic birth.

Study design: Descriptive study.

Subjects: Two hundred and sixty one pregnant women who delivered infant birth weight of ≥ 4,000 g. at BMA Medical College and Vajira Hospital between January 2005 and December 2007.

Methods: Mothers' demographic data, mode of delivery, maternal and fetal complications were collected from medical records and computer data base.

Main outcome measures: Maternal age, parity, gestational age, body mass index, overt or gestational diabetes, mode of delivery, maternal and fetal complications.

Results: The rate of macrosomic birth during the study period was 2.1%. The mean maternal age was 29.6 ±  6.0 years and 63.2% of the subjects were multiparity. Overt or gestational diabetes was found in 17.6%. Ninety-seven percent of pregnant women were obese at the time of delivery or last prenatal care. Thirty-seven percent of macrosomic deliveries occurred after 40 weeks of gestation. The cesarean section rate was 53.3%. Postpartum hemorrhage in cases with cesarean section was documented 23 times higher than those in women with vaginal delivery. Shoulder dystocia and Erb's palsy were found in 2.7% and 0.8% respectively.

Conclusion: Gestational diabetes and maternal obesity were the main pregnancy characteristics of macrosomic birth. Mode of delivery in fetuses with estimated weight ≥ 4,000 g should be carefully evaluated.

Vajira Med J 2009 ; 53 : 25 - 32