title: Determinants and outcome of fetal macrosomia in a Nigerian tertiary hospital.
abstract: BACKGROUND
  To determine the incidence and risk factors of fetal macrosomia and maternal and perinatal outcome.
  
  
  METHODS
  This was a 1-year prospective case-control study of singleton pregnancies in a Nigerian tertiary hospital. Only women who gave consent were recruited for the study. The maternal and perinatal outcomes in women who delivered macrosomic infants (birth weight ≥ 4000 g) were compared with the next consecutive delivery of normal birth weight (2500-3999 g) infants.
  
  
  RESULTS
  The total deliveries for the study period were 2437, of which 135 were macrosomic babies. The incidence of fetal macrosomia was 5.5%. The mean birth weights of macrosomic and nonmacrosomic babies were 4.26 ± 0.29 kg and 3.20 ± 0.38 kg, respectively, P = 0.000. Mothers with macrosomic babies were more likely to be older (P = 0.047), of higher parity (0.001), taller (P = 0.007), and weighed more at delivery (P = 0.000). Previous history of fetal macrosomia (P = 0.000) and maternal diabetes (P = 0.007) were factors strongly associated with the delivery of macrosomic infants. Pregnancies associated with fetal macrosomia had increased duration of labor (P = 0.007), interventional deliveries (P = 0.000), shoulder dystocia, and genital laceration (P = 0.000). There was no significant difference in the incidence of primary postpartum hemorrhage (P = 0.790), birth asphyxia, and perinatal mortality (P = 0.197).
  
  
  CONCLUSIONS
  Fetal macrosomia is associated with maternal and fetal morbidities. The presence of the observed risk factors should elicit the suspicion of a macrosomic fetus and the need for appropriate management to reduce maternal and fetal morbidities.
authors.affiliation: Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
authors.forename: Oghenefegor Edwin
authors.initials: OE
authors.lastname: Olokor
authors.affiliation: Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
authors.forename: Joseph Ubini
authors.initials: JU
authors.lastname: Onakewhor
authors.affiliation: Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure, Ondo State, Nigeria.
authors.forename: Adeniyi Kolade
authors.initials: AK
authors.lastname: Aderoba
keywords: Birth weight; fetal macrosomia; risk factors; shoulder dystocia