Maternal clinical profile and immediate neonatal outcome in term large for gestational age neonates

Pravati Jena, Santosh K. Panda, Manas Nayak, Soumini Rath, Deepti D. Pradhan


Background: The objective of the study was to know the maternal clinical profile and short term outcome of term large-for-gestational-age (LGA) neonates.

Methods: The study was a prospective observational study conducted in the tertiary neonatal unit, Odisha, during the study period February to November 2018. All inborn term neonates with birth weight above 90th percentile for gestational age excluding neonates with major congenital anomalies were included. Maternal clinical profile data from the antenatal records, neonatal demographic profile and co-morbidities over time were recorded using a checklist. The analysis of data was done using SPSS 21.0. Univariate summary statistics and bivariate Fischer’s exact test were used to analyse the data.

Results: The prevalence of delivery of LGA and macrosomic neonate in our institution was 2.5%, and 1.1% respectively. Ninety one percent of LGA neonates were born before 39weeks and 80% babies delivered by cesarean section. Majority 39 (86.7%) of LGA babies were born to non-diabetic mother, four (8.9%) neonates born to GDM mother, two (4.4%) were born to mother with pre pregnancy diabetes mellitus. Sixteen (35.5%) neonates were admitted to NICU for different comorbidities like neonatal jaundice (37.8%), polycythemia (24.4%), transient tachypnea of new-born (20%), hypoglycemia (15.6%), hypocalcaemia (15.6%), and seizure (4.4%). The comorbidities like hypoglycaemia, hypocalcemia, respiratory distress were more in LGA babies with diabetic mother compared to non-diabetic mother.

Conclusions: About nine in ten LGA neonates were born to non-diabetic mothers, however, LGA infants of diabetic mothers are at higher risk of metabolic complications like hypoglycemia, hypocalcemia compared to non-diabetic mother.


LGA neonate, Macrosomia, Comorbidities

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Henriksen T. The macrosomic fetus: a challenge in current obstetrics. Acta obstetricia etgynecologica Scandinavica. 2008;87(2):134-45.

Koyanagi A, Zhang J, Dagvadorj A, Hirayama F, Shibuya K, Souza JP, et al. Macrosomia in 23 developing countries: an analysis of a multicountry, facility-based, cross-sectional survey. Lancet. 2013;381(9865):476-83.

Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: associatiowith birth weight, maternal obesity, andgestational diabetes mellitus. Pediatrics. 2005;115(3):e290-296.

Hermann GMDL, Haskell SE, Roghair RD. Neonatal macrosomia is an independent risk factor for adult metabolic syndrome. Neonatology. 2010;98(3):238-44.

Langer O. Fetal macrosomia: etiologic factors. Clin Obstet Gynecol. 2000;43:283-97.

Linder N, Lahat Y, Kogan A, Fridman E, Kouadio F, Melamed N, et al. Macrosomic newborns of non-diabetic mothers: anthropometric measurements and neonatal complications. Arch Dis Child Fetal Neonatal Ed. 2014;99(5):353-8.

Mardani M, Kazemi KH, Mohsenzadeh A, Ebrahimzade F. Investigation of frequency and risk factors of macrosomia in infants of Asali hospital of Khoramabad city. Iran J Epidemiol. 2013;8(4):47-53.

Al-Qashar F, Al-Ghamdi M, Agab W. Prevalence and outcomes of macrosomic infants born to non-diabetic mothers: A ten years’ experience at tertiary care center. J Am Sci. 2016;12(12).

Akinbi HT, Gerdes JS. Macrosomic infants of nondiabetic mothers and elevated C-peptide levels in cord blood. J Pediatr. 1995;127(3):481-4.

Coustan DR, Lowe LP, Metzger BE, Dyer AR. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol. 2010;202(6):654-6.

Cetin H, Yalaz M, Akisu M, Kultursay N. Polycythaemia in infants of diabetic mothers: β-hydroxybutyrate stimulates erythropoietic activity. J Int Med Res. 2011;39(3):815-21.

Anjum SK, Yashodha H. A study of neonatal outcome in infants born to diabetic mothers at a tertiary care hospital Int J Contemp Pediatr. 2018;5(2):489-92.

Araz N, Araz M. Frequency of neonatal hypoglycemia in large for gestational age infants of non-diabetic mothers in a community maternity hospital. Acta Medica. 2006;49:237–9.