Hagos Gebretinsae Alem, Nerea Mekuria Kassa, Debesay Edris Abdu, Tequare Mengistu Hagazi, Abraha Hiluf Ebuy, Abebe Yohannes Tesfay, Ebrahim Mohamedawel Mohamedniguss
Mekelle University, College of Health Sciences, Mekelle, Ethiopia.
Lekatit 11 Primary Hospital, Mekelle, Ethiopia.
PLoS One. 2025 Jun 3;20(6):e0325541. doi: 10.1371/journal.pone.0325541. eCollection 2025.
Macrosomia, defined as a birth weight ≥4,000 grams, is linked to increased risks of cesarean delivery, postpartum hemorrhage, and neonatal morbidity, posing significant challenges in resource-limited regions like Northern Ethiopia., However, in Northern Ethiopia, evidence about the factors that lead to macrosomia is scarce. This study aimed to assess the factors associated with delivery of a macrosomic baby in public hospitals in Mekelle city, Northern Ethiopia.
A hospital-based, unmatched case control study design was implemented on 276 samples (184 controls and 92 cases) among newborns delivered in public hospitals of Mekelle City from February 21, 2020, to June 20, 2020. Cases and controls were selected using consecutive and systematic random sampling techniques, respectively. Data were collected using a structured questionnaire and a checklist and analyzed using SPSS. After describing the variables, bivariate and multivariable logistic regression models were employed to see the association between the factors and macrosomia. P < 0.05 was used to determine the statistical significance.
The multivariable model identified five factors that are significantly associated with macrosomia. As the age of the mother increases by one year, the odds of macrosomia were found to increase by 12% (AOR = 1.12, 95% CI: 1.02 to 1.23). As well, for each one-kilogram weight gain during pregnancy, the odds of macrosomia increased by 36% (AOR = 1.36, 95% CI: 1.12 to 1.65). And, one unit increment in body mass index was found to increase the odds of macrosomia by 26% (AOR = 1.26, 95% CI: 1.06 to 1.50). Likewise, the male sex of the newborn and history of macrosomia were found to increase the chance of macrosomia by 2.66 (AOR = 2.66, 95% CI: 1.08 to 6.56) and 3.59-fold (AOR = 3.59, 95% CI: 1.62 to 7.95), respectively.
In this study, the risk of macrosomia was found to be higher for male newborns, older mothers, greater weight gain during pregnancy, higher body mass index, and mothers with a history of macrosomia. This study has found both modifiable and non-modifiable risk factors of macrosomia. Policymakers should integrate preconception counselling and health education about the modifiable risk factors of macrosomia, such as weight gain during pregnancy. Big emphasis should be given to the male fetus and pregnant mothers with advanced age and history of macrosomia.
巨大儿定义为出生体重≥4000克，与剖宫产、产后出血及新生儿发病风险增加相关，这给像埃塞俄比亚北部这样资源有限的地区带来了重大挑战。然而，在埃塞俄比亚北部，关于导致巨大儿的因素的证据很少。本研究旨在评估埃塞俄比亚北部梅克内斯市公立医院中与巨大儿分娩相关的因素。
2020年2月21日至2020年6月20日在梅克内斯市公立医院分娩的新生儿中，对276个样本（184个对照和92个病例）实施了一项基于医院的非匹配病例对照研究设计。病例和对照分别采用连续和系统随机抽样技术选取。使用结构化问卷和检查表收集数据，并使用SPSS进行分析。在描述变量后，采用二元和多变量逻辑回归模型来观察因素与巨大儿之间的关联。P＜0.05用于确定统计学意义。
多变量模型确定了与巨大儿显著相关的五个因素。母亲年龄每增加一岁，巨大儿的几率增加12%（调整后比值比[AOR]=1.12，95%置信区间[CI]：1.02至1.23）。同样，孕期体重每增加1千克，巨大儿的几率增加36%（AOR=1.36，95%CI：1.12至1.65）。并且，体重指数每增加一个单位，巨大儿的几率增加26%（AOR=1.26，95%CI：1.06至1.50）。同样，新生儿为男性以及有巨大儿病史分别使巨大儿的几率增加2.66倍（AOR=2.66，95%CI：1.08至6.56）和3.59倍（AOR=3.59，95%CI：1.62至7.95）。
在本研究中，发现男性新生儿、年龄较大的母亲、孕期体重增加较多、体重指数较高以及有巨大儿病史的母亲发生巨大儿的风险更高。本研究发现了巨大儿的可改变和不可改变的风险因素。政策制定者应纳入关于巨大儿可改变风险因素（如孕期体重增加）的孕前咨询和健康教育。应高度重视男性胎儿以及年龄较大且有巨大儿病史的孕妇。
