Risk factors and obstetric complications associated with macrosomia.
OBJECTIVE
Macrosomia is associated with adverse maternal outcomes. The objective of this study was to characterize the epidemiology of macrosomia and related maternal complications.


METHODS
Live births (146,526) were identified between 1995 and 1999 in the Kaiser Permanente Medical Care Program's Northern California Region (KPMCP NCR) database. Bivariate and multivariate analyses were performed for risk factors and complications associated with macrosomia (birth weight >4500 g).


RESULTS
Male infant sex, multiparity, maternal age 30-40, white race, diabetes, and gestational age >41 weeks were associated with macrosomia (p<0.001). In bivariate and multivariate analyses, macrosomia was associated with higher rates of cesarean birth, chorioamnionitis, shoulder dystocia, fourth-degree perineal lacerations, postpartum hemorrhage, and prolonged hospital stay (p<0.01).


CONCLUSIONS
Macrosomia was associated with adverse maternal outcomes in this cohort. More research is needed to determine how to prevent complications related to excessive birth weight.
Stotland
N E
NE
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA.
Caughey
A B
AB
Breed
E M
EM
Escobar
G J
GJ
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D002821:Chorioamnionitis / Q000209:etiology; D015331:Cohort Studies; D019992:Databases as Topic; D004420:Dystocia / Q000209:etiology; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D022125:Lacerations / Q000209:etiology; D007902:Length of Stay; D008423:Maternal Age; D015999:Multivariate Analysis; D010298:Parity; D010502:Perineum / Q000293:injuries; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications; D011645:Puerperal Infection / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D000070599:Shoulder Injuries; D044465:White People