Risk factors for fetal macrosomia among mothers who delivered at Kawempe national referral hospital

Abstract

Introduction: Fetal macrosomia is defined as birth weight greater than or equal to 4000 g. The worldwide prevalence of birth of infants greater or equal to 4000gm is approximately 9 percent and approximately 0.1 percent for weight greater than 5000 gm. The prevalence of macrosomia varies widely among countries and may be as high as 15% in some areas. Maternal body mass index, excessive weight gain during pregnancy, advanced maternal age, multiparity, diabetes, previous history of macrosomia are some of the risk factors of fetal macrosomia. There are hardly any documented risk factors for fetal macrosomia in Uganda. This study aimed at determining the risk factors for fetal macrosomia among women who delivered at Kawempe National Referral Hospital. Methods: A 1:2 unmatched case-control study that recruited 531 women (177 cases and 354 controls) was conducted at Kawempe National Referral Hospital. An interviewer-administered questionnaire and review of clinical charts for additional or missing information were used to collect risk factors. Data analysis was done using STATA version 16.0 Results: The participants mean age for cases and controls were 28.5 ± 5.9 and 25.9 ± 5.4, P value <0.001 respectively. The risk factors for fetal macrosomia included:- maternal age greater or equal to 40 years (aOR = 7.4, 95%CI 1.37 - 39.44, P value = 0.020),Maternal weight greater or equal to 80kg (80 – 89kg, aOR = 4.0, 95%CI 2.15 - 7.40, P value <0.001), Maternal height greater or equal to 160cm (aOR = 1.6, 95%CI 1.02 - 2.51, P value = 0.040), Gestation age greater or equal to 40 weeks (aOR = 1.8, 95%CI 1.16 – 2.82, P value = 0.009), use of herbal medicines during pregnancy (aOR = 2.3, 95%CI 1.41 - 3.82, P value = 0.001) and Male babies (aOR = 1.78, 95%CI 1.14 - 2.77, P value = 0.011) Conclusions and recommendations. The risk factors for fetal macrosomia at Kawempe National Referral Hospital were: - maternal age greater or equal to 40years, the maternal weight of 80kg and above, a height greater than 160cm, being married, gestational age greater or equal to 40 weeks, history of previous macrosomic baby, use of herbal medicines during pregnancy and Male fetus. There is a need to design protocols on the assessment of risk factors for fetal macrosomia in ANC so that effective education, precautions, and timely interventions are implemented.