Influencing Factors of the Fetal Macrsomia and Antepartum Prediction

doi:10.3877/cma.j.issn.1673-5250.2014.06.022

Objective

To analyze influencing factors of fetal macrosomia in order to predict fetal macrosomia and select the appropriate mode of delivery.

Methods

From January to December 2012,a total of 429 cases of fetal macrosomia (birth weight ≥ 4 000g ) were analyzed retrospectively as research group (n= 429). Meanwhile 429 cases normal newborn (birth weight 2 500g~4 000g ) delivered in the same time were selected as control group(n = 429). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Hospital of Maternity and Children of Foshan. Informed consent was obtained from each participants. Clinical data of maternal age, height, gestational weeks at delivery, parity, maternal body weight in the 20th gestational week and before delivering, height of uterus, maternal abdominal circle, biparietal diameter (BPD), femur length (FL), gender of fetus, whether combined with hydramnion and gestational diabetes mellitus(GDM) or not,and delivery pattern were compared between two groups.

Results

There were significant differences between two groups in macrosomia, maternal age, height, gestational weeks at delivery, parity, maternal body weight in the 20th week pregnancy and before delivering, weight gain during pregnancy, height of uterus, maternal abdominal circle, BPD and FL(P< 0.05). The incidence rate of male fetal macrosomia was 1.84 times as much as female in research group. The incidence rates of hydramnion and GDM were obviously higher than those of control group (P <0.05). There was significant difference in cesarean section rate between two groups ( P < 0.05 ).

Conclusions

Maternal age, height, weight, gestational weeks at delivery, parity, height of uterus, maternal abdominal circle, combined with hydramnion or GDM are influencing factors of fetal macrosomia. Gravidogram and ultrasound may contribute to prenatal diagnosis of fetal macrosomia.

Key words: Fetal macrosomia, Risk factors, Prenatal diagnosis, Parturition

表1 2007 – 2012年巨大儿的年发生率变化情况[n(%)]

Table 1 Change tendency of incidence rates of fetal macrsomia from 2007 to 2012[n(% )]

年份（年）	分娩总数（例）	巨大儿发生率
2007	5 446	205 (3.76)
2008	6 029	233(3.87)
2009	6 227	242(3.89)
2010	6 623	265(4.00)
2011	7 992	322(4.03)
2012	10 174	429(4.21)
合计	42 491	1 716(4.04)

表1 2007 – 2012年巨大儿的年发生率变化情况[n(%)]

Table 1 Change tendency of incidence rates of fetal macrsomia from 2007 to 2012[n(% )]

年份（年）	分娩总数（例）	巨大儿发生率
2007	5 446	205 (3.76)
2008	6 029	233(3.87)
2009	6 227	242(3.89)
2010	6 623	265(4.00)
2011	7 992	322(4.03)
2012	10 174	429(4.21)
合计	42 491	1 716(4.04)

表2 两组分娩孕龄分布比较（孕周，±s）

Table 2 Comparison of distribution on gestational weeks at delivery between two groups(gestational weeks, ±s)

组别	例数	分娩孕龄[n(%)]					平均分娩孕龄
组别	例数	37~38孕周	38 ^{+ 1} ~ 39孕周	39 ^{+ 1}~ 40孕周	40⁺¹~41孕周	41⁺¹~42孕周	平均分娩孕龄
观察组	429	11 (2. 6)	65 (15.2)	99(23.8)	178(41.5)	77 (17.9)	40.61±1.28
对照组	429	47(11.0)	115 (26.8)	154(35.9)	92 (21.4)	21 (4.9)	38.82±1.37
t值		-	-	-	-	-	2.142
P值		-	-	-	-	-	<0.01

表2 两组分娩孕龄分布比较（孕周，±s）

Table 2 Comparison of distribution on gestational weeks at delivery between two groups(gestational weeks, ±s)

组别	例数	分娩孕龄[n(%)]					平均分娩孕龄
组别	例数	37~38孕周	38 ^{+ 1} ~ 39孕周	39 ^{+ 1}~ 40孕周	40⁺¹~41孕周	41⁺¹~42孕周	平均分娩孕龄
观察组	429	11 (2. 6)	65 (15.2)	99(23.8)	178(41.5)	77 (17.9)	40.61±1.28
对照组	429	47(11.0)	115 (26.8)	154(35.9)	92 (21.4)	21 (4.9)	38.82±1.37
t值		-	-	-	-	-	2.142
P值		-	-	-	-	-	<0.01

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