Risk factors for the delivery of macrosomic infants at the University Hospital of the West Indies.

Abstract

The aim of this study is to determine the risk factors for the delivery of macrosomic infants at the University Hospital of the West Indies over a 3-year period. A retrospective, descriptive, case-controlled study was performed. Data were extracted from the maternal medical records of 316 macrosomic infants (weighing ≥ 4,000 g) and 316 controls (weighing from 2,500-3,999 g) delivered at the University Hospital of the West Indies. Descriptive analyses were performed comparing maternal characteristics between the two groups. Risk factors were determined using multiple logistic regression models. The incidence of macrosomia for the study period was 4.3%. Women who delivered a macrosomic infant were older, taller, and heavier with a greater body mass index at the start of the pregnancy and gained more weight during pregnancy than their counterparts in the control group (p < 0.05). Maternal obesity, height > 164 cm, abnormalities of glucose control, weight gain > 15 kg, gestational age > 40 weeks, and male gender of the infant were found to increase the risk of delivering a macrosomic infant by over 2-fold (p < 0.05). The greatest risk factor was that of having had a previous macrosomic infant which increased the risk of delivering a macrosomic infant by as much as 6-fold (adjusted odds ratio, 6.0; 95% confidence interval, 1.9-18.7). The maternal risk factors for fetal macrosomia identified in this study mirror those of previous studies.