Department of Obstetrics and Gynaecology, Prince Mshiyeni Hospital.
HIV Research Group, Department of Obstetrics and Gynaecology, University of Kwa Zulu-Natal, South Africa.
Afr J Reprod Health. 2022 Jul;26(7):127-134. doi: 10.29063/ajrh2022/v26i7.13.
Despite extensive work on macrosomia, it is impossible to predict women at risk. Current prediction strategies which include clinical examination and ultrasound are imprecise. This study aims to determine the risk factors associated with macrosomia. It was a descriptive, retrospective chart review of women delivered of macrosomic neonates over a two-year period from 2015-2016. Detailed clinical and demographic information was recorded. Statistical analysis was carried out using SPSS (version 25.0 IBM, Armonk, New York, USA). Of 22 244 singleton deliveries, 415 were macrosomic infants (1.9%). The mean birth weight for macrosomic infants was 4.39 ± 0.43 (range 4-5.15) kg and males were more in number and weight. Macrosomic infants occurred more in age groups 25-29 years and peaked with BMI ≥30 kg/m2. Majority were cesarean sections compared to vaginal deliveries (56.6% vs 43.4%; p=0.006) respectively. Vaginal delivery of macrosomic infants was associated with complications. Significant differences were found between fetal macrosomia and clinical characteristics such as body mass index, parity, advanced maternal age, and male fetal sex. Hypoglycaemia was most frequent in infants born to non-diabetic mothers (98.1%). Antenatal risk factors are important in the prediction of macrosomia, but fetal and maternal outcome depends on labour management.
尽管已经对巨大儿进行了广泛的研究，但仍然无法预测有风险的女性。目前的预测策略包括临床检查和超声检查，但并不精确。本研究旨在确定与巨大儿相关的危险因素。这是一项对 2015 年至 2016 年期间两年内分娩巨大儿的女性进行的描述性、回顾性图表审查。记录了详细的临床和人口统计学信息。使用 SPSS（版本 25.0 IBM，Armonk，New York，USA）进行统计分析。在 22244 例单胎分娩中，有 415 例为巨大儿婴儿（1.9%）。巨大儿婴儿的平均出生体重为 4.39 ± 0.43（范围 4-5.15）kg，男性数量和体重更多。巨大儿婴儿更多出现在 25-29 岁年龄组，并且随着 BMI≥30 kg/m2 而达到高峰。与阴道分娩相比，剖宫产（56.6%对 43.4%；p=0.006）的比例更高。阴道分娩巨大儿婴儿与并发症有关。胎儿巨大儿与体重指数、产次、高龄产妇和男性胎儿性别等临床特征之间存在显著差异。非糖尿病母亲所生婴儿低血糖症最为常见（98.1%）。产前危险因素在预测巨大儿方面很重要，但胎儿和产妇的结局取决于分娩管理。
