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: 2500-3999g. 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. (C) 2011 Elsevier Ireland Ltd. All rights reserved.