Mallouli Manel, Derbel Mohamed, Ingrid Allegbe, Sahli Jihén, Zedini Chekib, Ajmi Thouraya, Mtiraoui Ali
Tunis Med. 2017 Feb;95(2):120-125.
Fetal macrosomia is associated with an increased risk of adverse outcomes to both the mother and the infant.
To determine maternal and neonatal outcomes associated to fetal macrosomia in diabetic and non- diabetic mothers.
It is a descriptive retrospective study conducted in Tunisia. We included in this study all patients who delivered newborns having a birth weight above 4kg during 2013. Multivariate analysis was performed using binary logistic regression to identify the complications associated to macrosomic pregnancies with diabetes.
Among the 10186 deliveries registered during the study period, 821 mothers gave birth to macrosomic newborns. The prevalence of macrosomia was 8.1%, and macrosomic newborns who had a birth weight of 4500 g or greater were 1.06%. Macrosomia was significantly higher in males (p <10-3). The rate of cesarean delivery was 47.9%. The most frequent adverse maternal and neonatal outcomes were perineal tears (3.6%), post-partum hemorrhage (0.6%), shoulder dystocia (4.9%) and neonatal intensive care unit admission (7.6%).The proportion of maternal diabetes was 9.3%. Macrosomic pregnancies with diabetes appear to be significantly associated with cesarean delivery (OR=2.22), postpartum hemorrhage (OR=6.69) and neonatal intensive care unit admission (OR=4.18).
Macrosomia increases the risk of maternal and perinatal morbidity particularly when it was associated to maternal diabetes.
巨大胎儿与母亲和婴儿出现不良结局的风险增加相关。
确定糖尿病和非糖尿病母亲中与巨大胎儿相关的母婴结局。
这是一项在突尼斯进行的描述性回顾性研究。本研究纳入了2013年期间分娩出生体重超过4千克新生儿的所有患者。采用二元逻辑回归进行多变量分析，以确定糖尿病巨大儿妊娠相关的并发症。
在研究期间登记的10186例分娩中，821名母亲分娩出巨大儿。巨大儿的患病率为8.1%，出生体重4500克或以上的巨大儿为1.06%。男性巨大儿的比例显著更高（p<10-3）。剖宫产率为47.9%。最常见的母婴不良结局是会阴撕裂（3.6%）、产后出血（0.6%）、肩难产（4.9%）和新生儿重症监护病房收治（7.6%）。母亲患糖尿病的比例为9.3%。糖尿病巨大儿妊娠似乎与剖宫产（比值比=2.22）、产后出血（比值比=6.69）和新生儿重症监护病房收治（比值比=4.18）显著相关。
巨大儿增加了母亲和围产期发病的风险，尤其是当它与母亲糖尿病相关时。
