Akin Yasemin, Cömert Serdar, Turan Cem, Piçak Abdülkadir, Ağzikuru Turgut, Telatar Berrin
Department of Pediatrics I, Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
Turk J Pediatr. 2010 Jul-Aug;52(4):378-83.
The objective of this study was to determine the incidence, perinatal complications and the outcome of macrosomic infants. A retrospective analysis was made of macrosomic deliveries and of those admitted into the Neonatology Unit. A control group of 854 deliveries weighing between 2500-4000 g was randomly composed. The incidence of macrosomic deliveries, stillbirth rates, sex, parity, maternal age, mode of delivery, perinatal complications like birth traumas, hypoglycemia, polycythemia, asphyxia, admission rate into the neonatal intensive care unit (NICU), and outcome were analyzed. Among a total of 11,827 deliveries, 829 (7%) were macrosomic neonates. Statistical analysis showed male predominance (p = 0.0001), a significant increase in cesarean section (p = 0.0001), and higher parity for the macrosomic group (p = 0.0001). The mothers of macrosomic newborns were older (p = 0.0001). The admission frequency of macrosomic deliveries into the NICU was almost two-fold. Birth injuries were found in 53 (6.4%) macrosomic infants, and macrosomic deliveries had a two-fold risk for birth injuries. Statistical analysis showed a significant difference between macrosomics and the control group for the frequency of birth traumas (p = 0.0007), hypoglycemia (p = 0.0001) and polycythemia (p = 0.0006). There were two deaths in macrosomic group versus one among control cases. Regarding the high birth trauma and NICU admission rates of macrosomic infants, it is important to emphasize the significance of prenatal diagnosis of fetal macrosomia and of management of these high-risk pregnancies in tertiary level hospitals.
本研究的目的是确定巨大儿的发生率、围产期并发症及结局。对巨大儿分娩病例及入住新生儿科的病例进行了回顾性分析。随机选取854例体重在2500 - 4000克之间的分娩病例作为对照组。分析了巨大儿分娩的发生率、死产率、性别、胎次、产妇年龄、分娩方式、围产期并发症如产伤、低血糖、红细胞增多症、窒息、入住新生儿重症监护病房(NICU)的比率以及结局。在总共11827例分娩中,829例(7%)为巨大儿。统计分析显示男性居多(p = 0.0001),剖宫产显著增加(p = 0.0001),巨大儿组的胎次更高(p = 0.0001)。巨大儿新生儿的母亲年龄更大(p = 0.0001)。巨大儿分娩入住NICU的频率几乎是两倍。53例(6.4%)巨大儿存在产伤,巨大儿分娩发生产伤的风险是两倍。统计分析显示巨大儿组与对照组在产伤频率(p = 0.0007)、低血糖(p = 0.0001)和红细胞增多症(p = 0.0006)方面存在显著差异。巨大儿组有2例死亡,对照组有1例死亡。鉴于巨大儿的高产伤率和NICU入住率,强调胎儿巨大儿产前诊断及三级医院对这些高危妊娠进行管理的重要性很有必要。