Fetal macrosomia greater than or equal to 4000 grams. Comparing maternal and neonatal outcomes in diabetic and nondiabetic women

Department of Obstetrics and Gynecology, Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia.
Saudi medical journal (Impact Factor: 0.59). 10/2008; 29(10):1463-9.
Source: PubMed


To compare maternal and neonatal outcomes of fetal macrosomia in diabetic and nondiabetic women.
A retrospective case-control study was conducted at Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia from January 2004 to December 2006. A total of 766 macrosomic newborns met the inclusion criteria. We compared maternal and neonatal characteristics and outcomes between diabetic (group 1, n=207) and nondiabetic (group 2, n=559) women.
There were significantly more macrosomic newborns in nondiabetic women; 73% versus 27% in diabetic women, p=0.0001. Cesarean deliveries were significantly higher in diabetic women compared to nondiabetic women (30.4% versus 19.5%, p=0.002). There were no significant differences between either group in total maternal morbidity (12.6% versus 14.1%, p=0.7). There were significantly more severe cases of shoulder dystocia occurring in newborns of diabetic women compared to nondiabetic women (1.9% versus 0.2%, p=0.03).
Elective cesarean delivery for estimated fetal weight > or =4500g for nondiabetic women and > or =4250 g for diabetic women may avoid severe shoulder dystocia without increasing maternal morbidity rates.

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    • "The highest reported prevalence is 20% in Nordic countries,[2] while 1.5% of neonates in the USA have a birth weight of ≥4.5 kg.[10] A previous study conducted in KSA from 2004 through 2006 reported a prevalence of 5.6% using the same birth weight definition,[11] which is greater than the rate in our report. A decline in the fetal macrosomia rate is supported by data from the National Vital Statistics; the USA has shown a significant, steady decline in the rate of fetal macrosomia using the same weight definition for macrosomia.[12] "
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