The Association between Birth Weight 4000g or Greater and Perinatal Outcome in Patients With and Without Gestational Diabetes Mellitus
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The Association between Birth Weight 4000g or Greater and Perinatal Outcome in Patients With and Without Gestational Diabetes Mellitus, BAHAA EL-DIN HASSANEIN, OSAMA Z. AHMED, HAITHAM A. TORKY, NAGY A. EL-HUSSIENY, MOHAMED F. EL-SODA and AMIRA M. KOLKAILA
Abstract
Fetal macrosomia is associated with adverse perinatal outcome. This includes stillbirth, neonatal mortality secondary to birth asphyxia, shoulder dystocia, birth injury, and meconium aspiration syndrome, and after birth, neonatal respiratory distress, hypoglycemia and hyperbilirubinaemia.
The aim of this study was to evaluate the association between birth weight 4000g or greater and perinatal outcome in mothers with and without gestational diabetes.
This study was carried out on 100 neonates of either diabetic or non diabetic mothers who were delivered in 6th October and Benha University Hospitals and Ahmed Maher Teaching Hospital during the period from November 2011 to August 2012. The neonates had been divided into two groups to compare between perinatal outcome (birth injury i.e. shoulder dystocia, and brachial plexus injury, neonatal respi-ratory distress, hypoglycemia and hyperbilirubinemia).
The 1st group (patients) included 50 newborns with birth weight 4000g or more, while the 2nd group (control) included 50 newborns with birth weight less than 4000g.
In the present study maternal Body Mass Index (BMI) has significant effect on neonatal birth weight, where the mothers with higher BMI have higher incidence to have macrosomic babies, the mothers with history of a macrosomic baby have higher incidence to have macrosomic baby, and the multiparous mothers have higher incidence to have a macrosomic baby than primiparas. Gestational Diabetes Mellitus (GDM) is a risk factor for macrosomia and other neonatal complications.
In the macrosomic group, 34 out of 50 newborn (68%) had no complications while the other 16 (32%) had compli-cations in the form of shoulder dystocia in 6%, jaundice in 10%, respiratory distress in 8%, hypoglycemia in 6%, and Erb's palsy in 2%, while in control, 41 out of 50 newborn (82%) had no complications and 9 (18%) had complications in the form of jaundice in 12%, respiratory distress in 4% and hypoglycemia in 2%.
In this study, we report that not only does birth weight of 4000 g or greater increase the prevalence of adverse perinatal outcomes such as hypoglycemia, RDS, shoulder dystocia and Erb's palsy, but also that GDM status increases this risk even further. When both birth weight of 4000g or greater and GDM are present, the effect estimates of these outcomes appear to be more than additive.