Abstract
Objective The aim of this study is to determine the risk factors for the delivery of macrosomic
infants at the University Hospital of the West Indies over a 3-year period.
Design and Methods A retrospective, descriptive, case-controlled study was performed. Data were extracted
from the maternal medical records of 316 macrosomic infants (weighing ≥ 4,000 g) and
316 controls (weighing from 2,500–3,999 g) delivered at the University Hospital of
the West Indies. Descriptive analyses were performed comparing maternal characteristics
between the two groups. Risk factors were determined using multiple logistic regression
models.
Results The incidence of macrosomia for the study period was 4.3%. Women who delivered a
macrosomic infant were older, taller, and heavier with a greater body mass index at
the start of the pregnancy and gained more weight during pregnancy than their counterparts
in the control group (p < 0.05). Maternal obesity, height > 164 cm, abnormalities of glucose control, weight
gain > 15 kg, gestational age > 40 weeks, and male gender of the infant were found
to increase the risk of delivering a macrosomic infant by over 2-fold (p < 0.05). The greatest risk factor was that of having had a previous macrosomic infant
which increased the risk of delivering a macrosomic infant by as much as 6-fold (adjusted
odds ratio, 6.0; 95% confidence interval, 1.9–18.7).
Conclusion The maternal risk factors for fetal macrosomia identified in this study mirror those
of previous studies.
Keywords
fetal macrosomia - risk factors - large for gestational age - abnormal glucose control
