Predictors of fetal macrosomia in Iringa, Tanzania: a case-control study

Abstract

Introduction: It is challenging to predict fetal macrosomia before delivery. This study aimed at assessing predictors of fetal macrosomia at Iringa Regional Referral Hospital in Tanzania from June to December 2020.
Method: An unmatched case-control study with 216 participants of whom 72 were cases - women who delivered babies weighing ≥ 4000g - and 144 were controls - women who delivered babies weighing 2500g to 3499g. The purposive sampling technique described below was employed to recruit both controls and cases. SPSS version 25 software program was used for data entry and analysis.
Results: Of the 216 participants, 116 (53.7%) were aged between 25 – 34 years (standard deviation 6.0). The majority of 132 (61.1%) delivered at a gestational age of 37 – 39 weeks + 6 days of whom 17 (23.6%) were cases and 115 (79.86%) were controls. The predictors of fetal macrosomia were advanced gestation age (AOR=8.10, 95% CI 3.66-17.91, p=<0.0001) and diabetes mellitus during pregnancy (AOR =14.94, 95% CI 1.60 -39.91, p= 0.0178).
Conclusion: Women with higher gestational age and gestational diabetes mellitus are at an increased risk of delivering a baby with macrosomia at Iringa Regional Referral Hospital. An early plan for the mode of delivery, such as labour induction, will aid the prevention of advanced gestational age. Ensuring a healthy diet and physical exercises in our communities will help to reduce diabetes mellitus and hence fetal macrosomia.