Study On Related Factors, Delivery Methods And Pregnancy Outcomes In 333 Cases Of Fetal Macrosomia.

Objective: To investigate the relationship of related factors,delivery methods and pregnancy outcomes in fetal macrosomia.Methods:①The clinical data of 333 cases of fetal macrosomia were enrolled in the study , and randomly selected 335 cases of pregnant women who delivered mature and normal weight fetus as control group.②Immunohistochemistry was used to measure glucagon-like peptide-1 and glucagon-like peptide-1 receptor levels in placenta from randomly selected 30 normal pregnant women(group AGA) in control group and randomly selected 28 women (group LGA) in fetal macrosomia group.Results:①The body mass index (BMI), biparietal diameter, femur length and the number of baby boy in fetal macrosomia group were significantly higher than that in control group(P<0.05).②The maternal age, gestational age, parity, late pregnancy's uterus height, abdominal circumference, bodyweight, amniotic fluid volume, the rate of gestational diabetes and expired pregnancy in fetal macrosomia group were significantly higher than that in control group(P<0.05). But the gravidity was no significant difference in two groups (P>0.05).③The rates of cesarean section, persistent occipito transverse position or posterior position, cephalopelvic disproportion, latency, protracted active phase, shoulder dystocia, uterine inertia, perineal laceration, premature rupture of membranes, fetal distress in uterus, neonatal asphyxia and postpartum hemorrhage in fetal macrosomia group were significantly higher than that in control group(P<0.05).④In comparison with the multiparas in fetal macrosomia, the primiparas in fetal macrosomia group showed increased rates of cesarean section(P<0.05).⑤In comparison with the less than 41 weeks gestational age's maternal, the more than 41 weeks gestational age's maternal in fetal macrosomias group showed increased rates of cesarean section(P<0.05).⑥In comparison with other two groups ,the rates of cesarean section were significantly higher in that group which birth weight is more than 4250g (P<0.05). In comparison with the group which birth weight is more than 4100g and less than 4250g, the rates of cesarean section in the group which birth weight is more than 4000g and less than 4100g were no significant difference(P>0.05).⑦In fetal macrosomia group, the incidence of fetal distress in uterus, neonatal asphyxia, birth trauma and postpartum hemorrhage were significantly elevated in vaginal delivery group in comparison with cesarean section group (P<0.05); the incidence of fetal distress in uterus, neonatal asphyxia and postpartum hemorrhage were significantly elevated in emergency cesarean section group in comparison with timely cesarean section group (P<0.05); the incidence of fetal distress in uterus, neonatal asphyxia, birth trauma and postpartum hemorrhage were significantly elevated in difficult vaginal delivery group in comparison with not difficult vaginal delivery group (P<0.05).⑧Glucagon-like peptide-1 and glucagon-like peptide-1 receptor levels in placenta in group LGA were significantly lower than that in group AGA(P<0.05).⑨Glucagon-like peptide-1 and glucagon-like peptide-1 receptor levels in placenta were negatively correlation with fetal birth weight (r=-0.454, P<0.05, r =-0.512, P<0.05).Conclusion:①The incidence of fetal macrosomia not only with their mother's age, gestational age, parity, late pregnancy's uterus height, abdominal circumference, bodyweight, amniotic fluid volume, the rates of gestational diabetes and expired pregnancy, but also closely related to the sex of fetal.②Glucagon-like peptide-1 and glucagon-like peptide-1 receptor levels in placenta may be play an important role in controlling fetal growth weight.③The choice of delivery methods should be based on fetal weight, parity, gestational age and maternal conditions during the whole pregnancy.④Regular antenatal examination, pregnant women's reasonable diets and movement in accordance with their pregnancy, select proper delivery methods, broadening indicatio of cesarean section, timely childbirth and correctly handle the delivery process are effective measures to early prevent and diagnose the fetal macrosomia and reduce the incidence of complications for both mothers and fetuses.