The Prevalence of Macrosomia in Newborns and Its Association with Maternal Diabetes

Objective: To find out the prevalence of macrosomic births and its obstetric outcome in diabetic and non diabetic maternities of Saudi nationality of Al-Jouf Region. Material and Methods: This one year study was carried out from January 2012 to December 2012 in Department of Obstetrics and Gynaecology at “Al-Jouf Maternity and Children Hospital”, Sakakha, Al-Jouf Region. Kingdom of Saudi Arabia. All patients having given birth to a singleton newborn weighing 4000 g or more, and those having diabetes and delivered of a singleton neonate after 37 completed weeks of gestation were included in the study group. Mothers name, admission number, noted from labour and delivery register and the case files requested from the hospital’s patient record section. Information was collected on performa and analyzed using SPSS version 16. Results: Out of 3820 singleton maternities of Saudi nationality, the frequency of macrosomia was (8.21%). The mean maternal age was 30.30 years ± 5.3 standard deviation. Out of the 314 mothers of macrosomic newborns, 157 (50%) were grand multi gravida and 76(24.2%) were postdate. Eighty six mothers were known diabetic at the time of delivery and of these, 26 (30.23%) had macrosomic births. The odds of having a macrosomic newborn were 5 times for mothers with diabetes compared to mothers without diabetes. The overall caesarean section rate in 314 maternities with macrosomic newborns was 38.9%. Diabetic mothers with macrosomic newborn, however had a higher chance of caesarean delivery 73% with no incidence of shoulder dystocia in this group. The frequency of shoulder dystocia was 2.08% in total macrosomic births compared to the rate of 0.155% seen in non-macrosomic newborns delivered vaginally in the same study period. Based on increasing birth weight, the macrosomic newborns were further divided into three groups and the difference in shoulder dystocia was noted to be statistically significant with increasing birth weight. Conclusions: Diabetes puts an infant at higher risk of macrosomia and mothers at higher risk of caesarean section. Fetal macrosomia are increased 5 times by maternal diabetes.