Complications and Risk Factors of Neonatal Macrosomia: A Case-Control Study

Abstract

Background: Macrosomia is defined as the birth weight of greater than or equal to 4,000 grams, which is considered to be a public health issue threatening mothers and neonates. Studies indicate that the prevalence rate of macrosomia is on the rise in developing countries. The present study aimed to evaluate the influential factors in the occurrence of neonatal macrosomia. Methods: This case-control study was conducted at Al-Zahra Hospital in Tabriz, located in the north-west of Iran, during March 2013-February 2014. Sample population included all the live-born neonates and their mothers. The case group consisted of the neonates with the birth weight of ≥4,000 grams (n=404), and the control group included 404 newborns weighing 2,500-3,999 grams. Data were collected using a maternal and neonatal information form (maternal age, neonatal gender, mode of delivery, maternal height, and maternal history of diabetes). Data were extracted from the medical files of the samples and recorded in the form. Data analysis was performed in SPSS version 20 using descriptive and inferential statistics (independent t-test and 2χ) at the significance level of α=0.05. Results: In total, 8,012 neonates were born during the study, 404 of whom has macrosomia (5.04%). Mean maternal age in the case and control groups was 29.6±6.1 and 27.9±8.3 years, respectively (P<0.001). Significant differences were observed in the gender (male) (odds ration [OR]=2.2 [95% CI: 1.33-3.04]; P<0.001), mode of delivery (OR=0.51 [95% CI: 0.37-0.69]; P<0.001), maternal history of diabetes (OR=4.5 [95% CI: 2.3-8.73]; P<0.001), and number of deliveries (birth rank) (OR=1.6 [95% CI: 1.19-2.39]; P<0.001) between the case and control groups. Conclusion: According to the results, there were significant associations between macrosomia at birth and maternal age, maternal history of diabetes, and birth rank. Therefore, proper planning and educational interventions are recommended for the control of the influential factors in the occurrence of macrosomia.