Exploring fetal macrosomic status in Sétif

Abstract

Fetal macrosomia (FM), defined as a birth weight of 4000 grams or more, remains a significant obstetric concern due to its association with increased risks of adverse outcomes for both mother and newborn. These complications include postpartum hemorrhage, prolonged labor, and perineal tears, as well as neonatal complications including shoulder dystocia, birth trauma, and even perinatal mortality. This retrospective descriptive study was conducted at El-Bez Mother and Child Hospital in Sétif, Algeria, covering the period from January 2020 to December 2024, and aimed to establish an epidemiological profile of macrosomia in Sétif region during the last 5 years, and to describe the maternal and neonatal characteristics, associated risk factors, and potential complications. Out of 48513 total deliveries, 3677 macrosomic cases were recorded, yielding a prevalence of 7.6%. The mean birth weight was 4216.9 ± 265.5 g, and the majority of macrosomic newborns were male (61.6 %). Deliveries were mostly at term (79.9 %). Normal vaginal delivery was the most common mode (48.4 %), followed by caesarean section (40.3%) and obstructed labor (11.3%). Maternal age ≥30 years was reported in 56% of cases, while maternal comorbidities were observed in 9.4% of cases, with gestational diabetes accounting for 5.6% and chronic hypertension for 3%. Multiparity was observed in 28.8% of mothers. Neonatal complications included shoulder dystocia (11.3%), perinatal death (10 cases). The Apgar score was ≥ 8 in 80.2% of newborns, while 18.5% had a score <8. These findings highlight the significance of early identification and management of maternal risk factors during pregnancy. Enhanced antenatal monitoring and timely obstetric intervention are essential to minimize both maternal and neonatal complications associated with fetal macrosomia.