Neonatal outcome of macrosomic infants: an analysis of a two-year period

Objective

To assess the neonatal outcome of macrosomic neonates in uncomplicated, singleton, term deliveries.

Study design

A retrospective analysis was performed on 5738 live-born term neonates born in the period 2008–2009. The neonatal outcomes were compared between two birth weight (BW) groups: the macrosomic neonates born with BW ≥ 4000 g and a control group: 2500–3999 g. There were 410 (7.1%) neonates in the macrosomic group, 4757 (82.9%) in the control group, while 571 (10.0%) were less than 2500 g at birth. A correlation analysis of two subgroups of the macrosomic neonates (4000–4499 g vs. ≥4500 g) was also carried out.

Results

The rate of caesarean section (CS) was significantly higher in the macrosomic group as compared with the control group (49.3% vs. 39.9%), as were the prevalences of hypoglycaemia (6.1% vs. 2.9%), adrenal haemorrhage (0.98% vs. 0.15%) and the male to female ratio (2.15 vs. 0.95). The rate of icterus was significantly higher in the control group (30.4% vs. 18.5%). The macrosomic subgroups were similar in many aspects, but we found significantly more neonates in the higher weight subgroup as regards a low Apgar score, clavicle fracture and the need for intensive care.

Conclusions

The macrosomic infants were born in good general condition, although those with BW ≥4500 g more frequently had an adverse outcome. The macrosomic and control groups’ data revealed significant differences in the rate of CS, the male to female ratio, hypoglycaemia and adrenal haemorrhage.