Prevalence of Macrosomia in Iran: A Systematic Review and Meta-Analysis

Background: Macrosomia is a risk factor for adverse maternal and neonatal outcomes and previous studies have reported different prevalence of macrosomia in Iran. We conducted a meta-analysis to estimate the overall prevalence of macrosomia in Iran. Materials and Methods: A systematic review and meta-analysis was conducted of all published literature pertaining to prevalence rates of macrosomia using international and national electronic databases ISI Web of Knowledge, PubMed, Scopus, SID, Magiran and Google Scholar from their inception until June 2017 with standard keywords. Egger test and Funnel plot were used to evaluate the publication bias and Cochran test and I2 statistics were used to examine the statistical heterogeneity. Pooled estimate of the prevalence of macrosomia were calculated using random effects meta-analysis. Results: A total of 40 studies were included in this meta-analysis. The publication bias assumption was rejected Egger test (P=0.719) and Funnel plot. The results of Cochran test and I2 statistics revealed substantial heterogeneity (Q=1040.5.00, df = 39, P2=96.3%). The overall prevalence of macrosomia using the random effect model in Iran was 5.2% (95% confidence interval [CI]: 4.4-5.9). Moreover, the macrosomia prevalence in Tehran and other cities were 3.9% (95% CI: 3.2-4.7) and 6.0% (95% CI: 5.0-7.1), respectively. Conclusion:The macrosomia rate in Iran is high. There is a critical need to improve the education and the gestational care and identifying at risk neonates to reduce the macrosomia rate and its adverse outcomes.