Perinatal outcome of macrosomic births in Port Harcourt

Macrosomic babies are at increased risk of adverse perinatal outcome and therefore constitute a high risk group of neonates and the incidence appears to be rising. The objective was to determine the incidence of fetal macrosomia, and the perinatal outcome of macrosomic babies, compare with matched term, appropriate weight neonates in the booked antenatal population of the UPTH.

It was a one year prospective study of the perinatal outcome of singleton babies whose birth weights were 4000 g and above (macrosomia) delivered to booked antenatal mothers in UPTH between 1st October 2003 and 30th September 2004, comparing them with term appropriate (2500-3999 g) weight babies. The birth weight, sex, perinatal and maternal complications documented from direct observations, questioning and other information extracted from patients' case notes, were entered into a personal computer, analysed and presented as frequency tables, percentages, Chi-square X2, calculated as appropriate using Epi info version 3.4.3 statistical software. P < 0.05 was considered statistically significant.

Fetal macrosomia occurred in 354 out of 2417 singleton term deliveries, giving an incidence of 1 in 7 deliveries or 14.65%. The birth asphyxia (7.90% vs 2.60%, p = 0.011), Neonatal admission (29.54% vs 2.85%, p = 0.001) and perinatal mortality (48/1000 vs 23/1000 births, p = 0.001), caesarean delivery (55.70% vs 18.64%, p = 0.001) rates were significantly higher in the macrosomic than the control group.

There is a high incidence of fetal macrosomia in Port Harcourt with associated relatively higher adverse perinatal outcome compared to singleton term normal weight babies.