The Turkish Journal of Pediatrics
2010 , Vol 52 , Num 4
Macrosomic newborns: a 3-year review
Departments of 1Pediatrics I and 2Obstetrics and Gynecology, Dr. Lütfi Kırdar Kartal Training and Research Hospital,
İstanbul, Turkey
The objective of this study was to determine the incidence, perinatal
complications and the outcome of macrosomic infants. A retrospective analysis
was made of macrosomic deliveries and of those admitted into the Neonatology
Unit. A control group of 854 deliveries weighing between 2500-4000 g was
randomly composed. The incidence of macrosomic deliveries, stillbirth rates,
sex, parity, maternal age, mode of delivery, perinatal complications like birth
traumas, hypoglycemia, polycythemia, asphyxia, admission rate into the
neonatal intensive care unit (NICU), and outcome were analyzed. Among a
total of 11,827 deliveries, 829 (7%) were macrosomic neonates. Statistical
analysis showed male predominance (p=0.0001), a significant increase in
cesarean section (p=0.0001), and higher parity for the macrosomic group
(p=0.0001). The mothers of macrosomic newborns were older (p=0.0001).
The admission frequency of macrosomic deliveries into the NICU was almost
two-fold. Birth injuries were found in 53 (6.4%) macrosomic infants, and
macrosomic deliveries had a two-fold risk for birth injuries. Statistical analysis
showed a significant difference between macrosomics and the control group
for the frequency of birth traumas (p=0.0007), hypoglycemia (p=0.0001)
and polycythemia (p=0.0006). There were two deaths in macrosomic group
versus one among control cases. Regarding the high birth trauma and NICU
admission rates of macrosomic infants, it is important to emphasize the
significance of prenatal diagnosis of fetal macrosomia and of management
of these high-risk pregnancies in tertiary level hospitals.
Keywords :
macrosomia, birth injuries, NICU admission.