Fetal macrosomia: demographic analysis and perinatal performance in a Chinese population.

Abstract

AbstractA retrospective analysis of the demographic and perinatal data of 332 macrosomic infants (≥3.8 kg) born of Chinese mothers in a teaching hospital in Hong Kong was performed. Results were compared with similar data from 334 normal weight infants (>2.5 to <3.8 kg) randomly selected in the same year. The incidence of fetal macrosomia was 5.7% of the annual deliveries. Significant maternal risk factors were increased maternal age, high pre‐pregnant weight and ponderal index, positive history of previous macrosomic babies and presence of maternal diabetes. The incidence of diabetes mellitus was 13.6%. Clinical suspicion of macrosomia before delivery was positive in only 31.0%, of cases. The uterine volume index (UVI) at term was calculated by the formula: UVI = (Fundal heightXAbdominal girth2/4π. When the UVI was >34.0 litres, the predictive value for macrosomia was 40% with a false positive rate of only 2.2%. Meconium stained liquor and caesarean section were more common. First stage of labour was comparable but second stage was significantly prolonged. Among macrosomic infants, male: female ratio was 1.7: 1. Birth trauma and neonatal jaundice were more common. Maternal diabetes is a significant contributory factor which may justify screening of the maternity population to allow early detection and treatment.