Complications and Risk Factors of Neonatal Macrosomia: A Case-Control Study

Authors

1 Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran

3 Social Determinants of Health Research Center, Community and Family Medicine Specialist, Tabriz University of Medical Sciences, Tabriz, Iran

4 Department of Medical, Urmia University of Medical Sciences, Urmia, Iran

Abstract

Background: Macrosomia is defined as the birth weight of greater than or equal to 4,000 grams, which is considered to be a public health issue threatening mothers and neonates. Studies indicate that the prevalence rate of macrosomia is on the rise in developing countries. The present study aimed to evaluate the influential factors in the occurrence of neonatal macrosomia.
Methods: This case-control study was conducted at Al-Zahra Hospital in Tabriz, located in the north-west of Iran, during March 2013-February 2014. Sample population included all the live-born neonates and their mothers. The case group consisted of the neonates with the birth weight of ≥4,000 grams (n=404), and the control group included 404 newborns weighing 2,500-3,999 grams. Data were collected using a maternal and neonatal information form (maternal age, neonatal gender, mode of delivery, maternal height, and maternal history of diabetes). Data were extracted from the medical files of the samples and recorded in the form. Data analysis was performed in SPSS version 20 using descriptive and inferential statistics (independent t-test and 2χ) at the significance level of α=0.05.
Results: In total, 8,012 neonates were born during the study, 404 of whom has macrosomia (5.04%). Mean maternal age in the case and control groups was 29.6±6.1 and 27.9±8.3 years, respectively (P<0.001). Significant differences were observed in the gender (male) (odds ration [OR]=2.2 [95% CI: 1.33-3.04]; P<0.001), mode of delivery (OR=0.51 [95% CI: 0.37-0.69]; P<0.001), maternal history of diabetes (OR=4.5 [95% CI: 2.3-8.73]; P<0.001), and number of deliveries (birth rank) (OR=1.6 [95% CI: 1.19-2.39]; P<0.001) between the case and control groups.
Conclusion: According to the results, there were significant associations between macrosomia at birth and maternal age, maternal history of diabetes, and birth rank. Therefore, proper planning and educational interventions are recommended for the control of the influential factors in the occurrence of macrosomia.

Keywords


1. Mardani M, Kazemi KH, Mohsenzadeh A, Ebrahimzade F. Investigation of frequency and risk factors of macrosomia in infants of Asali hospital of Khoramabad city. Iran J Epidemiol. 2013; 8(4):47-53.
2. Mathew M, Machado L, Al-Ghabshi R, AlHaddabi R. Fetal macrosomia. Risk factor and outcome. Saudi Med J. 2005; 26(1):96-100.
3. Dennedy MC, Dunne F. Macrosomia: defining the problem worldwide. Lancet. 2013; 381(9865):435-6.
4. Koyanagi A, Zhang J, Dagvadorj A, Hirayama F, Shibuya K, Souza JP, et al. Macrosomia in 23 developing countries: an analysis of a multicountry, facility-based, cross-sectional survey. Lancet. 2013; 381(9865):476-83.
5. Maroufizadeh S, Omani SR, Amini P, Sepidarkish M. Prevalence of macrosomia and its related factors among singleton live-birth in Tehran province, Iran. J Isfahan Med Sch. 2016; 34(394): 940-5 (Persian).
 6. Bahrami N, Soleimani MA. Study of some related factors with fetal macrosomia and low birth weight. J Urmia Nurs Midwifery Facul. 2014; 12(2):136-43.
7. Haji ET, Kazemi H, Kordi M. Prevalence and outcome of the macrosomic infants. Acta Med Iran. 2007; 45(6):505-9.
8. Li G, Kong L, Li Z, Zhang L, Fan L, Zou L, et al. Prevalence of macrosomia and its risk factors in china: a multicentre survey based on birth data involving 101,723 singleton term infants. Paediatr Perinat Epidemiol. 2014; 28(4):345-50.
 9. Tian C, Hu C, He X, Zhu M, Qin F, Liu Y, et al. Excessive weight gain during pregnancy and risk of macrosomia: a meta-analysis. Arch Gynecol Obstet. 2016; 293(1):29-35.
 10. Yadav H, Lee N. Factors influencing macrosomia in pregnant women in a tertiary care hospital in Malaysia. J Obstet Gynaecol Res. 2014; 40(2):439-44.
 11. Fakhri M. Evaluation of maternal and neonatal complications in macrosomia. J Mazandaran Univ Med Sci. 1999; 9(24):32-8.
 12. Mohammadbeigi A, Farhadifar F, Soufi Zadeh N, Mohammadsalehi N, Rezaiee M, Aghaei M. Fetal macrosomia: risk factors, maternal, and perinatal outcome. Ann Med Health Sci Res. 2013; 3(4):546-50.
13. Mardani M, Rossta S, Rezapour P. Evaluation of the prevalence of macrosomia and the maternal risk factors. Iran J Neonatol. 2014; 5(3):5-9.
 14. Najafian M, Cheraghi M. Occurrence of fetal macrosomia rate and its maternal and neonatal complications: a 5-year cohort study. ISRN Obstet Gynecol. 2012; 353791(10):14.
15. He XJ, Qin FY, Hu CL, Zhu M, Tian CQ, Li L. Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis? Arch Gynecol Obstet. 2015; 291(4):729-35.
 16. Ghanbari Z, Emamzadeh A, Bagheri M. The prevalence and risk factors of fetal macrosomia: a cross sectional study of 2000 neonates. Tehran Univ Med Sci J. 2008; 66:1-2.
17. Linder N, Lahat Y, Kogan A, Fridman E, Kouadio F, Melamed N, et al. Macrosomic newborns of nondiabetic mothers: anthropometric measurements and neonatal complications. Arch Dis Child Fetal Neonatal Ed. 2014; 99(5): F353-8.