American Journal of Clinical Medicine Research, 2014, Vol. 2, No. 4, 79-83
Available online at http://pubs.sciepub.com/ajcmr/2/4/4
© Science and Education Publishing
DOI:10.12691/ajcmr-2-4-4
Yearly Trends in Fetal Macrosomia among Hospital
Births in Enugu, South East Nigeria
Iyoke CA
1,*
, Lawani OL
2
, Ugwu GO
1
, Ezugwu FO
3
, Ilechukwu GC
4
1
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku- Ozalla, Enugu
2
Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki
3
Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu
4
Department of Paediatrics, Whiston Hospital, St Helen’s and Knowsley Teaching Hospitals NHS Trust, Prescot, United Kingdom
*Corresponding author: caiyoke@yahoo.co.uk
Received August 17, 2014; Revised August 24, 2014; Accepted August 27, 2014
Abstract Fetalmacrosomia is associated with higher risks of maternal and neonatal complications and with health
risks in adulthood. Trends in fetal macrosomia could indicate fetal growth patterns and its knowledge could be
useful for prenatalcare and maternal health education. The objective of the study was to describe the yearly trends in
the prevalence of fetal macrosomia among singleton live term hospital births in Enugu, South East Nigeria.
Routinely collected delivery data of three major maternity centres in Enugu were reviewed for the period January
2003 to December 2013. All singleton term live births that took place at the three centres during the study period
were analysed and the yearly prevalences of fetal macrosomia were determined. Statistical analysis involved
descriptive and inferential statistics at 95% level of confidence. A total of 22,628 singleton live term deliveries were
studied. There were 2116 births of macrosomic babies giving a prevalence rate of 9.3% of singleton term deliveries.
The mean weight of all macrosomic babies was 4.42kg ± 0.38. The prevalence rates of macrosomia showed a small,
but significant decreasing trend over the period of study. The likelihood of fetal macrosomia was increased by male
births (aOR 1.64, 95% confidence interval [C.I.] 1.10, 3.20); postdate births (aOR 2.1, 95% C.I. 1.4, 4.1) and
multiparity (aOR 8.0, 95% C.I. 3.2, 16.4). It was concluded that there was a decreasing trend in the prevalence of
fetal macrosomia in the study centres,and factors such as the prevalences of male births, postdate pregnancies and
multiparity could have influenced this, at least in part. However, population based studies incorporating prenatal
weight and medical complication data would be needed to establish the factors responsible for the actual trend in
macrosomic births in the general population in this area.
Keywords: fetal macrosomia, trend, birth weight, prevalence, Nigeria
Cite This Article: Iyoke CA, Lawani OL, Ugwu GO, Ezugwu FO, and Ilechukwu GC, “Yearly Trends in
Fetal Macrosomia among Hospital Births in Enugu, South East Nigeria.” American Journal of Clinical Medicine
Research, vol. 2, no. 4 (2014): 79-83. doi: 10.12691/ajcmr-2-4-4.
1. Introduction
Fetal macrosomia, defined as birth weight greater than
or equal to 4kg, has been associated with increased
maternal and fetal complications during delivery [1].
These complications include low Apgar scores, birth
injuries, fresh stillbirths, shoulder dystocia, prolonged
labour, obstructed labour, uterine rupture genital tract
lacerations and postpartum haemorrhage [1,2,3,4].
Maternal risk factors for macrosomia include advancing
maternal age, high parity, maternal obesity, diabetes in
pregnancy, previous history of macrosomia, maternal tall
height, and excessive pregnancy weight gain while fetal
risk factors include postdatism, male sex [1,2,3,4].
Reports show that the trends in the prevalence of fetal
macrosomia vary across different regions of the world
with contrasting trends in the occurrence of macrosomia
reported from the USA, Asia and Europe. A decreasing
trend in fetal macrosomia in the USA has been ascribed to
decrease in fetal growth [5]. However, a report from
Sweden indicatedan increase in fetal macrosomia which
was attributed to increases in maternal body mass indices
and decrease in smoking among pregnant women [6].
Similarly a studyfrom China showed an increase in
macrosomia due to increase in net gestational weight gain
[7]. Although several studies from our area have
demonstrated increased feto-maternal complications in
births involving macrosomic babies [8,9,10], we found no
studies on the trends in the prevalence of fetal macrosomia
in South East Nigeria. The aim of this study was to
describe the temporal trends in the prevalence of fetal
macrosomia among singleton term hospital births in
Enugu, South East Nigeria in the last decade.
2. Methodology
The study centres included two teaching hospitals in
Enugu namely the University of Nigeria Teaching hospital
Ituku-Ozalla, and the Enugu State University Teaching