Complications associated with the macrosomic fetus

Area of Science:

• Obstetrics
• Perinatology
• Neonatal Studies

Background:

• Macrosomia, defined as infants weighing over 4,500 g, is associated with increased maternal and fetal risks.
• Previous studies indicate potential complications, but a comprehensive comparison with a normal birth weight group is warranted.

Purpose of the Study:

• To compare the incidence of adverse maternal and fetal outcomes in deliveries of macrosomic infants versus normal birth weight infants.
• To identify specific risk factors and complications associated with macrosomic deliveries.

Main Methods:

• A retrospective study involving 525 infants weighing over 4,500 g.
• Comparison with a control group of infants weighing 2,500-4,000 g.
• Analysis of maternal demographics, pregnancy complications, delivery methods, and neonatal outcomes.

Main Results:

• Macrosomic deliveries showed higher rates of grand multiparity, diabetes mellitus, pregnancy-induced hypertension, advanced maternal age, placenta previa, and excessive maternal weight gain.
• Instrumental delivery and cesarean section rates were significantly higher in the macrosomic group, with cephalopelvic disproportion as the primary indication.
• Postpartum hemorrhage, shoulder dystocia, oxytocin augmentation, and birth canal tears were more frequent in macrosomic deliveries.
• Maternal and fetal morbidity, and perinatal mortality were significantly elevated in the macrosomic group, linked to difficult second-stage labor.

Conclusions:

• Macrosomic infants present a significantly higher risk profile for both mother and neonate.
• Cesarean delivery is strongly recommended for macrosomic fetuses, with an exception for women with a history of delivering a macrosomic infant.
• Management strategies should focus on mitigating risks associated with difficult labor progression in macrosomic pregnancies.