Since difficult vaginal delivery is more frequent with macrosomic fetuses, routine cesarean section is recommended for the delivery of fetuses. The purpose of this study was to evaluate the maternal and neonatal complications according to the method of delivery. This retrospective case control study was conducted comparing 232 macrosomic neonates weighing over 4kg. to a control group of 476 neonates, with mean birth weight of 2500 to 3999g. The MACROSOMIA occurred in 4.3% of deliveries in 1997 at Imam Khomaini hospital, Tehran. Cesarean section was carried out in 22.5% of macrosomic babies as compared to 15.7% of the controls. The most frequent indication for cesarean section was failure to progress and fetal distress. Post -partum hemorrhage and use of oxytocin to accelerate the labor was occurred significantly more in the study group. Shoulder dystocia and meconium in liquid occurred significantly more in the macrosomic group as neonatal complications. In comparison between the fetal & maternal outcomes for the macrosomic group delivered vaginally versus C/S showed that more injuries of genital canal took place in vaginal delivery. This type of delivery is a reasonable alternative to elective cesarean section for infants with birth weights of less than 5000g. And a trial of labour can be offered. Furthermore, the occurrence of P.P.H shoulder dystocia and meconium in liquid is more frequent in macrosomic group. So, it may be of value to consider more diligence in identifying the macrosomic fetus prior to delivery in order to an appropriate approach in these cases.    

Background: MACROSOMIA is a risk factor for adverse maternal and neonatal outcomes and previous studies have reported different prevalence of MACROSOMIA in Iran. We conducted a meta-analysis to estimate the overall prevalence of MACROSOMIA in Iran. Materials and Methods: A systematic review and meta-analysis was conducted of all published literature pertaining to prevalence rates of MACROSOMIA using international and national electronic databases ISI Web of Knowledge, PubMed, Scopus, SID, Magiran and Google Scholar from their inception until June 2017 with standard keywords. Egger test and Funnel plot were used to evaluate the publication bias and Cochran test and I2 statistics were used to examine the statistical heterogeneity. Pooled estimate of the prevalence of MACROSOMIA were calculated using random effects meta-analysis. Results: A total of 40 studies were included in this meta-analysis. The publication bias assumption was rejected Egger test (P=0. 719) and Funnel plot. The results of Cochran test and I2 statistics revealed substantial heterogeneity (Q=1040. 5. 00, df = 39, P<0. 001 and I2=96. 3%). The overall prevalence of MACROSOMIA using the random effect model in Iran was 5. 2% (95% confidence interval [CI]: 4. 4-5. 9). Moreover, the MACROSOMIA prevalence in Tehran and other cities were 3. 9% (95% CI: 3. 2-4. 7) and 6. 0% (95% CI: 5. 0-7. 1), respectively. Conclusion: The MACROSOMIA rate in Iran is high. There is a critical need to improve the education and the gestational care and identifying at risk neonates to reduce the MACROSOMIA rate and its adverse outcomes.

Background: MACROSOMIA is defined as the birth weight of greater than or equal to 4, 000 grams, which is considered to be a public health issue threatening mothers and neonates. Studies indicate that the prevalence rate of MACROSOMIA is on the rise in developing countries. The present study aimed to evaluate the influential factors in the occurrence of neonatal MACROSOMIA. Methods: This case-control study was conducted at Al-Zahra Hospital in Tabriz, located in the north-west of Iran, during March 2013-February 2014. Sample population included all the live-born neonates and their mothers. The case group consisted of the neonates with the birth weight of ≥ 4, 000 grams (n=404), and the control group included 404 newborns weighing 2, 500-3, 999 grams. Data were collected using a maternal and neonatal information form (maternal age, neonatal gender, mode of delivery, maternal height, and maternal history of diabetes). Data were extracted from the medical files of the samples and recorded in the form. Data analysis was performed in SPSS version 20 using descriptive and inferential statistics (independent t-test and 2χ ) at the significance level of α =0. 05. Results: In total, 8, 012 neonates were born during the study, 404 of whom has MACROSOMIA (5. 04%). Mean maternal age in the case and control groups was 29. 6± 6. 1 and 27. 9± 8. 3 years, respectively (P<0. 001). Significant differences were observed in the gender (male) (odds ration [OR]=2. 2 [95% CI: 1. 33-3. 04]; P<0. 001), mode of delivery (OR=0. 51 [95% CI: 0. 37-0. 69]; P<0. 001), maternal history of diabetes (OR=4. 5 [95% CI: 2. 3-8. 73]; P<0. 001), and number of deliveries (birth rank) (OR=1. 6 [95% CI: 1. 19-2. 39]; P<0. 001) between the case and control groups. Conclusion: According to the results, there were significant associations between MACROSOMIA at birth and maternal age, maternal history of diabetes, and birth rank. Therefore, proper planning and educational interventions are recommended for the control of the influential factors in the occurrence of MACROSOMIA.

Fetal MACROSOMIA was defined as birth weight greater than 4000g. Perinatal mortality and morbidity is increased in fetal MACROSOMIA.If we predict of fetal MACROSOMIA, prevention of its complications are possible. In a prospective study 3oo full term fetus among pregnant women that refered to the radiology department of AL-Zahra hospital for pregnancy sonography was sekcted. Fetal abdominal subcutaneous tissue thickness was meassured in the anterior third of the abdominal circumference.There were 294 normal size and 6 macrosomic fentses. The fetal abdominal subcutaneous tissue thickness ranged between 3 and 14 mm. in all fetuses with a mean measurement of 6.68 mm ± 1.77 S.D. The mean soft tissue thickness differed significantly between normal and macrosomic fetuses (6.57 mm ± 1.6 S.D verS1LS 12mm ± 1.41 S.D). The pearson correlation coefficient was cakulated (r=0.863 P<0.0001). The results of this study show, presence of direct relationship between the thickness of fetal subcutanous tissue and fetal weight, and measurement of this thickness in the full term pregnant woman could be used as a sonographic parameter for intrauterine diagnosis of MACROSOMIA.

Introduction: The prevalence of obesity is increasing in both developed and developing nations. Body mass index (BMI) is the most common index for obesity assessment and its relation with most complications among non-pregnant and pregnant women is known. However, no study has evaluated the relation between abdominal obesity and MACROSOMIA among pregnant women.Methods: In this prospective study, anthropometric indices including weight, height, and waist circumference (WC) of 1140 nulliparous pregnant women during their first trimester of pregnancy (6th-10th weeks) were measured by the researcher. According to the classification of the World Health Organization, women with BMI>25 kg/m2 were considered as overweight or obese. Abdominal obesity was defined as WC≥88 cm. Finally, mothers were followed up and fetal MACROSOMIA was recorded in a checklist. Data was analyzed in SPSS15.Results: The results showed that 77.5% of women aged 20-35 years and 92.7% were housewives. The mean (SD) values of BMI and WC were 24.32 (4.08) kg/m2 and 81.84 (9.25) cm, respectively. The prevalence of overweight (BMI=25-29.9 kg/m2) and obesity (BMI>29.9 kg/m2) was 27.6% and 8.8%, respectively. Abdominal obesity based on WC was found in 34.8% of the subjects.Conclusion: Findings of this study revealed obesity in over one third of nulliparous pregnant women during their first trimester. Moreover, the high prevalence of MACROSOMIA, in these women confirmed the importance of maternal education about obesity-related complications in order to change their lifestyle and prevent obesity.

Background: Birth weight are the major factors determining the physical and mental development of infants and credible signs of intrauterine growth. The purpose of this study was the Study of birth weight on maternal and neonatal factors in the women referred to delivery room of Specialized Hospital in 2010.Materials and Methods: In this cross sectional study, 3076 women with the normal vaginal delivery (NVD) entered into the study population. The Statistical Package for the Social Sciences, SPSS 17 for Windows, was used for the analysis. Data analysis was performed by using descriptive and analytical statistics (mean±SD), Chi-square test, independent sample t test, ANOVA, post hoc scheffe and liner regression). The significant level was set at less than 0.05 (p<0.05).Results: The prevalence rate of low birth weight was 6.7% (205) and MACROSOMIA 3.2% (97). Average neonatal birth weight was 3248.18±458 g and maternal age was 25.33±5.7 years. On the basis of linear regression, types and number of delivery, neonatal sex, preeclampia and age of mother were respectively the most factors of low birth weight. None of them relate to MACROSOMIA.Conclusion: Our findings showed by detection and control of many factors which relate to birth weight, we can decrease prevalence of low birth weight and MACROSOMIA and result in normal birth weight.

Background and Objective: Fetal MACROSOMIA increases the risk of perinatal mortality and morbidity. The aim of this study was to determine the prevalence of MACROSOMIA and its relationship with related factors in neonates born in the hospitals affiliated to Mashhad University of Medical Sciences. Methods: This cross-sectional study was performed on 97569 neonates using the data obtained from the neonates' screening program in Mashhad. Their information was extracted from Sina electronics system (electronic medical records software) and analyzed using SPSS 16. The prevalence of MACROSOMIA and its related factors are revealed by tables. Findings: In this study, the prevalence of MACROSOMIA was estimated at 6. 6 % which was higher in male neonates than females. The mean birth weight was higher in male infants than female ones. It occurred 8. 25 times higher in singletons than multiplets. The prevalence of MACROSOMIA was increased by maternal age (P=0. 001). Most of the neonates were born by cesarean section, and in most of them, the parents were not relatives. The prevalence of MACROSOMIA gradually increased in parents living in densely populated cities and its trend gently decreased from the beginning to the end of the year. Conclusion: The prevalence of MACROSOMIA in infants in Mashhad was 6. 6% and was correlated with maternal age during pregnancy, infant's gender, number of fetuses, mode of delivery, parental consanguinity, parental residence places and birth season.

MACROSOMIA (birth weight < 4000g) is associated with a variety of maternal risk factors. Abnormality of carbohydrate metabolism during pregnancy, which may not be detectable by glucose tolerance test (GTT) has been suggested as one of the main factors.Method: We measured blood glucose, glycated hemoglobin (HbA1C), insulin, fructosamine and peptide immediately after delivery in 3 groups of mothers. (1) 23 known diabetic and gestational diabetic mothers. (2) 49 non-diabetic mothers. These two groups delivered full-term macrosomic infants (3) 46 non-diabetic mothers who delivered full-term appropriate for gestational age infants as control.Result: Mothers of macrosomic infants, compared to mothers of appropriate for gestational age infants, were significantly older, with a higher gravidity and parity. When all the mean values were adjusted for maternal age, parity and gravidity, the HbA1C, fructosamine and glucose were lowest in mothers of appropriate for gestational age infants and highest in diabetic mothers of macrosomic infants. Hypoglyceaemia was more common in both groups of macrosomic infants and the cord blood fructosamice and insulin were not different.Conclusion: Although the trend of material blood samples in our study was suggestive of some abnormal carbohydrate metabolism in mothers who delivered macrosomic infants compared of appropriate for gestational age infants, these findings have not been confirmed in their babies. The possible role of abnormal glucose metabolism as a risk factor for fetal MACROSOMIA in non-diabetic mothers should be further studied.

Background: MACROSOMIA, characterized by excessive fetal growth, is common in infants born to women with pre-gestational diabetes and gestational diabetes mellitus (GDM). However, MACROSOMIA, which leads to birth-related maternal and fetal complications and metabolic complications in the adolescence of the affected fetuses, also occurs in the pregnancies of non-diabetic women. This study aims to identify the association between second-trimester lipid profiles and MACROSOMIA in non-diabetic pregnant women to aid in early diagnosis. Methods: This retrospective cohort study included 8,956 patients who delivered at a tertiary care center between 2017 and 2019. Exclusion criteria encompassed pre-existing diabetes, GDM, preeclampsia (PE), intrahepatic cholestasis of pregnancy, obesity, fetal chromosomal or genetic abnormalities, tobacco, alcohol, or drug use affecting lipid metabolism. Participants were divided into two groups: 621 with MACROSOMIA and 873 controls. Second trimester maternal lipid profiles and demographic variables such as age, pregnancy week, and gender were assessed. Results: In the study cohort, maternal age (P=0.002), gestational week (P=0.003), and cesarean section rate (P<0.001) were higher in the macrosomic group. High-density lipoprotein-cholesterol (HDL-C) was significantly lower, while total cholesterol (TC), triglycerides (TG), and low-density lipoprotein-cholesterol (LDL-C) were significantly higher in the macrosomic group (P<0.001). Univariate analysis revealed positive associations between second-trimester TG (OR 1.023, 95% CI: 1.020‒1.033, P<0.001), TC (OR 1.023, 95% CI: 1.016‒1.030, P<0.001) and LDL-C (OR 1.036, 95% CI: 1.018-1.054, P<0.001) with MACROSOMIA and a negative association with HDL-C (OR 0.954, 95% CI: 0.923‒0.976, P<0.001). However, after adjusted multivariable logistic analysis, only TG remained statistically significantly associated with MACROSOMIA (OR 1.054, 95% CI: 1.033‒1.076, P<0.001). Conclusion: Our study emphasizes the importance of early recognition and prevention of MACROSOMIA. Structured prospective studies are needed to enhance MACROSOMIA prediction and implement preventive measures, such as dietary modifications. These strategies will be crucial in preventing birth-related complications and long-term health risks, including diabetes, obesity, and cardiovascular diseases, associated with MACROSOMIA.