MACROSOMIC BIRTHS IN A TERTIARY PUBLIC HOSPITAL A SURVEY OF MATERNAL CHARACTERISTICS AND FETAL OUTCOME

Abstract

BACKGROUND: Macrosomic fetuses are high risk with their delivery process being associated withpotential risk to both mother and baby The aim of this study is to determine the incidence of macrosomicbirths and the associated maternal characteristics and to ascertain the fetal outcome.METHODS: It was a retrospective survey of maternal characteristics and pregnancy outcome ofmacrosomic births. Comparison was made with the next selected normal birth weight delivery during thestudy period.RESULTS: There were 8607 deliveries during the period (3 years) reviewed. Of this, 306 weremacrosomic deliveries, a frequency of 3.6%. The mean weight for macrosomic babies was 4.23kg (range4.01 – 5.62kg). There was a higher mean maternal weight and gestational age of mothers withmacrosomic deliveries compared to mothers in the control group, (85.87  19.39kg vs 74.92  19.11kgP<0.01; and 41.51  1.46 vs 39.02  1.29, P<0.001). Caesarean delivery was significantly associated withmacrosomic births compared to controls, p<0.0001, odds ratio 3.977. Also, asphyxia and shoulderdystocia occurred more in macrosomic babies, 10.4% vs 2.9% and 2.28% vs 0.65%, P<0.001. Themajority of the asphyxiated babies amongst macroomic births were following vagina delivery comparedto caesarean delivery, (65.6% vs 34.4%) p= 0.001. There were 3 cases of still birth in the macrosomicdeliveries, but no maternal deaths were encountered.CONCLUSION: Macrosomic births could be tragic. Although delivery outcome seems better with acaesarean section, good fetal outcome can only be assured on the premise of astute labour and deliverymanagement.