Maternal factors associated with large for gestational age babies and its outcome when compared with those of appropriate for gestational age

Abstract

INTRODUCTIONFoetal macrosomia is a common obstetrical problem affecting 20% babies born at term.1 Conventionally babies with birth weight more than 90th percentile is considered to be large for gestational age and those between 5 th and 90 th percentile as appropriate for gestational age. The birth weight cut-off may be based on absolute birth weight or greater than a particular percentile for the babies of that gestational age.2 Large for gestational age babies can lead to complications during delivery like prolonged labour, shoulder dystocia, birth injuries, post-partum haemorrhage, increased need for caesarean sections for cephalopelvic disproportion, anaesthetic complications and thromboembolic events. Also neonatal adverse outcomes of hypoglycemia, hypomagnesemia and hyperbilirubinemia are more common in these babies. 4 Antenatal detection of large for gestational age foetus will be helpful in anticipating these complications. This study is undertaken to determine the maternal factors associated with this condition so that the complications can be anticipated and managed in a better manner if not prevented. METHODSThis study was conducted in a tertiary care center based on collection of retrospective data about large for gestational age (LGA) babies born over a period of one year. The inclusion criteria were singleton pregnancies which resulted in LGA babies over this period of time. All the mothers who delivered babies who were large for ABSTRACT Background: Large for gestational age (LGA) babies are known to have a higher incidence of birth trauma, difficult delivery and Caesarean sections. Knowledge about maternal factors associated with this can help in prediction and prevention of complications. Methods: Maternal factors in 112 cases of LGA babies was studied along with its outcome and compared with an equal number of controls. Results: 0.05% deliveries resulted in LGA babies. Age and parity were not significantly different in the two groups and so were the associated medical disorders of hypothyroidism and gestational hypertension. Significant association was found with post-dated pregnancies (p=0.04) and gestational diabetes mellitus (p=0.05). Also, higher number of primary Caesarean sections resulted in the case group. Conclusions: Post dated pregnancies and gestational diabetes were maternal factors associated with LGA babies and higher number of primary Caesarean sections resulted in these cases.

Evaluation of the relationship between birth weight percentiles and perinatal outcomes in uncomplicated term pregnant women with large birth weight according to gestational age

“…Çok az sayıda çalışmaya göre LGA'nın respiratuar distres sendromu, doğum yaralanması, hipoglisemi, polisitemi, perinatal asfiksi ve mortalite ile ilişkisi gösterilmiştir 1 14,15 . Bu çalışmada ölü doğum ve yenidoğan ölüm oranları açısından literatüre benzer şekilde gruplar arasında fark görülmedi 8 .…”