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Macrosomia--maternal, fetal, and neonatal implications

H D Modanlou, W L Dorchester, A Thorosian

    Obstetrics and Gynecology
    |April 1, 1980
    PubMed
    Summary

    Neonatal macrosomia, defined as birth weight 4500 g or more, increases risks during delivery. However, macrosomic fetuses show no greater fetal distress in monitored labor, with excess neonatal intensive care unit admissions stemming from the delivery process itself.

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    Area of Science:

    • Obstetrics and Gynecology
    • Neonatal Perinatal Medicine

    Background:

    • Perinatal morbidity and mortality are elevated in macrosomic neonates (birth weight ≥ 4500 g).
    • Macrosomia complicates 1.3% of deliveries, with a 2.3:1 male-to-female ratio.

    Purpose of the Study:

    • To compare perinatal outcomes between macrosomic and appropriate-weight neonates.
    • To identify risk factors associated with fetal macrosomia.

    Main Methods:

    • Retrospective study comparing 287 macrosomic neonates with 284 appropriate-weight controls.
    • Analysis of maternal factors, intrapartum events, and neonatal outcomes.

    Main Results:

    • Maternal obesity, multiparity, diabetes mellitus, and prior delivery of a large infant ( > 4000 g) were associated with macrosomia.

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  • Macrosomic infants experienced higher rates of labor augmentation, shoulder dystocia, and cesarean section.
  • Macrosomic fetuses did not exhibit increased fetal distress during biophysically monitored labor.
  • Neonatal intensive care unit admission was significantly higher for macrosomic infants (10%) versus controls (3%).

    • Conclusions:

    • While macrosomic fetuses do not show increased distress in monitored labor, the delivery process leads to significant neonatal morbidity.
    • Risk factors for macrosomia include maternal obesity, multiparity, and diabetes mellitus.