Factors influencing macrosomia in pregnant women in a tertiary care hospital in Malaysia

摘要

Aim: To identify the risk factors influencing the development of macrosomia among pregnant women and to develop a regression model to predict macrosomia. Methods: A cross-sectional study was conducted in a tertiary hospital in Malaysia involving 2332 pregnant women. The data was retrospectively collected from the obstetrics and gynecology department. The factors that influence fetal weight were collected from the antenatal cards and any additional information was collected by face-to-face interview using a questionnaire. A multiple regression model was developed to predict macrosomia using SPSS ver. 18. Results: The significant variables that influence macrosomia in this study were mother's age, mother's body mass index (BMI), weight gain, parity, mother's ethnicity, father's BMI, gestational week, diabetes during pregnancy and neonatal sex. Diabetes during pregnancy is an important risk factor for macrosomia; by using this parameter alone the risk of macrosomia can be predicted with a sensitivity rate of 70% and specificity of 70%. By including other maternal factors such as maternal age, pre-pregnancy BMI, weight gain, parity, ethnicity, as well as father's BMI, gestational weeks and neonate sex, the sensitivity and specificity were improved to 80% and 75%, respectively. Conclusion: A regression model was developed and this could be used in health centers to predict macrosomia for purpose of referral to higher centers.