Clinical risk score to recognize macrosomia at the time of delivery.

OBJECTIVE

To develop a clinical risk score to help in recognizing macrosomia at the time of delivery.

METHODS

A case-control data analysis was conducted at a university-affiliated general hospital in Lamphun, Thailand. Macrosomic cases were 67 women who delivered babies weighing at least 4000 g. Controls were 779 women with babies weighing between 2500 g. and <4000 g. The best predictors were selected by multivariable logistic regression and transformed into clinical risk scores.

RESULT

The best combination of predictors included parity, gestational age at delivery, weight at delivery and symphysis-fundal height. The scores predicted macrosomia correctly with an AuROC of 94.1% (95% CI; 92.3, 95.6). The likelihood ratio of positive for macrosomia was 0 in the low risk category and 10.68 (95% CI; 7.76, 14.68) in the high risk.

CONCLUSION

A simple clinical risk score may help obstetricians suspect macrosomia at the time of delivery in areas where antenatal care services are inadequate.