Risk Factors And Complications Associated With Macrosomia In 153 Cases

Objective:This study explores the risk factors and complications of macrosomiaObjects and methods:Selection on November 1,2017 to January 31,2020 visits the First Hospital of Jilin University single full-term fetal macrosomia in hospital(BW≥4000 g)in 153 cases as observation group(macrosomia group),and the same period in the Jilin University First Hospital obstetric delivery term singleton newborns(2500~3999g)birth weight in 70 cases as control group(normal group)were retrospectively analyzed.1 、Comparison of macrosomia related risk factors between the control group and the observation group,including maternal age,pre-pregnancy body mass index,pregnancy weight gain,number of pregnancies,number of births,gender of newborn,and presence of blood glucose abnormalities during pregnancy(including GDM and PGDM);2、The related complications of the control group and the observation group were compared,including whether the newborn had clavicular fracture,brachial plexus nerve injury,shoulder dystocia,polycythemia,hyperbilirubinemia,fetal intrauterine distress,neonatal asphyxia,NRDS,neonatal pneumonia,myocardial hypertrophy,neonatal hypoglycemia,HIE,and thrombosis.3、In the macrosomia group,according to macrosomia mother whether there is abnormal blood sugar during pregnancy,macrosomia can be divided into abnormal blood sugar during pregnancy macrosomia group and normal blood glucose during pregnancy macrosomia group,compared two groups of related complications,including whether neonatal brachial plexus injury clavicle fractures,shoulder dystocia,red blood cells increased disease,high blood bilirubin,fetal distress,neonatal asphyxia,NRDS,myocardial hypertrophy,neonatal hypoglycemia,neonatal pneumonia,HIE,thrombosis.Statistical method:SPSS20.0 software was used for statistical analysis of the data.The measurement data were statistically described by mean± standard deviation((?) x±s),and t test was used for comparison between the two groups.The number of cases and percentage/frequency of counting data [n(%)] were statistically described,and the chi-square test was used for comparison between the two groups.The risk factors of macrosomia were evaluated by unconditioned multivariate Logistic regression analysis,and P < 0.05 was considered statistically significant.Result:1 、 There were statistically significant differences between the two groups in maternal age,pre-pregnancy BMI,pregnancy weight growth value,maternal blood glucose abnormality during pregnancy,and neonatal gender,etc.(P <0.05).There was no statistically significant difference between the two groups in number of pregnancies and number of births(P > 0.05).2、 Multivariate Logistic regression analysis of the above significantly different risk factors showed that abnormal blood glucose during pregnancy(OR value 5.487),weight gain during pregnancy(OR value 3.123),and pre-pregnancy BMI(OR value 2.466)were independent risk factors for macromacroia(P < 0.05).3、The observation group of neonatal hyperbilirubinemia,disease of grow in quantity of NRDS,polycythemia,neonatal hypoglycemia,fetal distress,shoulder dystocia,neonatal pneumonia,neonatal asphyxia,HIE,brachial plexus injury,myocardial hypertrophy,thrombosis significantly higher than the control group,difference has statistical significance(P < 0.05),while the differences of clavicle fracture has no statistical significance(P > 0.05).4、in the observation group(in the macrosomia),abnormal blood sugar during pregnancy macrosomia group of neonatal hyperbilirubinemia,disease of grow in quantity of NRDS,polycythemia,neonatal hypoglycemia,neonatal pneumonia,shoulder dystocia,HIE,neonatal asphyxia,myocardial hypertrophy,thrombosis,brachial plexus injury significantly higher than normal blood glucose during pregnancy macrosomia group,difference has statistical significance(P < 0.05),and fetal intrauterine distress,differences of clavicle fracture has no statistical significance(P > 0.05).Conclusion:1、The risk factors for the occurrence of macrosomia include abnormal blood glucose during pregnancy,weight gain during pregnancy,BMI before pregnancy,sex of newborn,and age of pregnant mother.2、The independent risk factors for macrosomia ranged from high to low: abnormal blood glucose during pregnancy,weight gain during pregnancy,and BMI before pregnancy.3 、 Compared with children of normal birth weight,macrosomia is more prone to complications from high to low:hyperbilirubinemia,NRDS,polycythemia,neonatal hypoglycemia,fetal intrauterine distress,shoulder dyspareunium,neonatal pneumonia,neonatal asphyxia,HIE,brachial plexus nerve injury,cardiac hypertrophy,and thrombosis.4 、 In macrosomia,with the mother during pregnancy macrosomia,compared to the normal blood glucose yields mother macrosomia from the abnormal blood sugar during pregnancy are more likely to occur in complications from the high order: high bilirubin hematic disease,disease of grow in quantity of NRDS,red blood cells,neonatal hypoglycemia,neonatal pneumonia,shoulder dystocia,HIE,neonatal asphyxia,myocardial hypertrophy,thrombosis,brachial plexus injury.