Universidade Federal de Minas Gerais Belo HorizonteMG Brasil Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Rev Bras Ginecol Obstet. 2024 Jun 27;46. doi: 10.61622/rbgo/2024rbgo48. eCollection 2024.
Evaluate the prevalence of macrosomic newborns (birth weight above 4000 grams) in a high-risk maternity from 2014 to 2019, as well as the maternal characteristics involved, risk factors, mode of delivery and associated outcomes, comparing newborns weighing 4000-4500 grams and those weighing above 4500 grams.
This is an observational study, case-control type, carried out by searching for data in hospital's own system and clinical records. The criteria for inclusion in the study were all patients monitored at the service who had newborns with birth weight equal than or greater than 4000 grams in the period from January 2014 to December 2019, being subsequently divided into two subgroups (newborns with 4000 to 4500 grams and newborns above 4500 grams). After being collected, the variables were transcribed into a database, arranged in frequency tables. For treatment and statistical analysis of the data, and software were used. This tool was used to create graphs and tables that helped in the interpretation of the results. The statistical analysis of the variables collected included both simple descriptive analyzes as well as inferential statistics, with univariate, bivariate and multivariate analysis.
From 2014 to 2019, 3.3% of deliveries were macrosomic newborns. The average gestational age in the birth was 39.4 weeks. The most common mode of delivery (65%) was cesarean section. Diabetes mellitus was present in 30% of the deliveries studied and glycemic control was absent in most patients. Among the vaginal deliveries, only 6% were instrumented and there was shoulder dystocia in 21% of the cases. The majority (62%) of newborns had some complication, with jaundice (35%) being the most common.
Birth weight above 4000 grams had a statistically significant impact on the occurrence of neonatal complications, such as hypoglycemia, respiratory distress and 5th minute APGAR less than 7, especially if birth weight was above 4500 grams. Gestational age was also shown to be statistically significant associated with neonatal complications, the lower, the greater the risk. Thus, macrosomia is strongly linked to complications, especially neonatal complications.
评估 2014 年至 2019 年高危产妇中巨大儿（出生体重超过 4000 克）的发生率，以及所涉及的产妇特征、危险因素、分娩方式和相关结局，比较出生体重为 4000-4500 克和超过 4500 克的新生儿。
这是一项观察性研究，病例对照型，通过在医院自身系统和临床记录中搜索数据进行。纳入研究的标准是在 2014 年 1 月至 2019 年 12 月期间在该服务处监测的所有患者，其新生儿出生体重等于或大于 4000 克，随后分为两个亚组（出生体重为 4000 至 4500 克和出生体重超过 4500 克的新生儿）。收集完变量后，将其转录到数据库中，排列成频率表。使用 和 软件对数据进行处理和统计分析。该工具用于创建图形和表格，以帮助解释结果。对收集的变量进行了简单描述性分析和推断性统计分析，包括单变量、双变量和多变量分析。
2014 年至 2019 年，3.3%的分娩为巨大儿新生儿。出生时的平均胎龄为 39.4 周。最常见的分娩方式（65%）是剖宫产。研究中 30%的分娩存在糖尿病，大多数患者血糖控制不佳。在阴道分娩中，只有 6%的患者使用了器械，21%的患者发生了肩难产。大多数（62%）新生儿有一些并发症，其中黄疸（35%）最常见。
出生体重超过 4000 克与新生儿并发症的发生有统计学意义，如低血糖、呼吸窘迫和第 5 分钟 Apgar 评分低于 7，尤其是出生体重超过 4500 克时。胎龄也与新生儿并发症有统计学意义的关联，胎龄越低，风险越大。因此，巨大儿与并发症密切相关，尤其是新生儿并发症。
