A study of fetal macrosomia

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Endocrinology

Background:

• Fetal macrosomia, defined as birthweight ≥4000g, is a significant obstetric concern.
• Maternal and neonatal complications associated with macrosomia require further investigation.

Purpose of the Study:

• To characterize maternal factors associated with fetal macrosomia.
• To assess fetal and maternal complications in pregnancies with macrosomia.
• To evaluate the risk of impaired glucose tolerance in mothers of macrosomic infants.

Main Methods:

• Comparative study of 956 cases of fetal macrosomia versus 6407 controls (non-macrosomic infants).
• Analysis of maternal characteristics (age, weight, parity), pregnancy complications (gestosis), delivery outcomes (birth injuries, operative deliveries), and glucose metabolism markers (oral glucose tolerance test, umbilical insulin).

Main Results:

• Mothers of macrosomic infants were significantly older, had higher parity, and greater pre-pregnancy weight.
• Fetal macrosomia was associated with increased rates of gestosis, operative deliveries, birth injuries, and postpartum hemorrhage.
• Abnormal oral glucose tolerance test (oGTT) results were observed in 26.2% of mothers, and 34% of macrosomic infants had elevated umbilical insulin levels.
• Macrosomic infants, more frequently male, had a higher risk of shoulder dystocia and birth injuries.

Conclusions:

• Pregnancy with fetal macrosomia is linked to specific maternal demographic and clinical factors.
• Fetal macrosomia presents increased risks for both maternal and neonatal complications, including impaired glucose tolerance.
• Early identification of risk factors and monitoring for complications are crucial in managing pregnancies with suspected fetal macrosomia.