Determinants of fetal macrosomia among live births in southern Ethiopia: a matched case-control study

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Determinants of fetal macrosomia among live births in southern Ethiopia: a matched case-control study

Background The magnitude of fetal macrosomia is high and associated with adverse maternal and fetal outcomes, especially among women in developing countries like Ethiopia. Despite the observed burden, there is limited evidence on determinants of fetal macrosomia. This study aimed to identify determinants of fetal macrosomia among live births at Wolaita Sodo town Southern Ethiopia. Methods A facility-based matched case-control study design involved 360 singletons deliveries attended at hospitals in Wolaita Sodo town, southern Ethiopia, with 120 cases and 240 controls included. Cases and control were matched by maternal age. Cases were neonates with a birth weight of ≥4000, while controls were neonates with a birthweight between 2500gm and less than 4000gm. Data were collected by interviews, measuring, and reviewing mothers' medical documents. Conditional logistic regression analysis was carried to identify the independent predictor variables. Statistical significance was set using a p-value<0.05 and 95% CI for AOR. Results Male neonates were four times more likely to be macrosomia than female neonates AOR=4.0 [95%CI; 2.25-7.11, p<0.001]. Neonates born at gestational age ≥40 weeks were 4.33 times more likely to be macrosomia with AOR= 4.33 [95%CI; 2.37-7.91, p<0.001]. Neonates born from physically active mothers were 7.76 times more likely to be macrosomia with AOR= 7.76 [95CI; 3.33-18.08, p<0.001]. Neonates born from mothers who consumed fruits and dairy products in their diet frequently were 2 and 4.9 times more likely to be macrosomia AOR=2.03 [95%CI; 1.11-3.69, p=0.021] and AOR= 4.91[95%CI; 2.36-10.23, p<0.001] respectively. Conclusion Mothers' physical exercise and consumption of fruit and dairy products were significant predictor variables for fetal macrosomia. Hence, health care providers may use these factors as a screening tool for the prediction, early diagnosis, and timely intervention of fetal macrosomia and its complications.

Regional Variation and Factors Associated With Fetal Macrosomia in Ethiopia

Background: Globally, there is an increase in the prevalence and incidence of fetal macrosomia. In Sub-Sahara African countries including Ethiopia, all infants were not weighed at birth, and there is a limit to knowledge regarding fetal macrosomia in Ethiopia. The main objective of this study is to assess the regional variation and determinants of fetal macrosomia using the multilevel logistic regression model.Methods: The study was based on the recent Ethiopian Demographic and Health Survey of 2016. A total of 2110 weighted infants at birth were extracted. Multilevel logistic regression analysis is performed to identify the factors associated with fetal macrosomia after various candidate models for their efficiency have been compared based on Akaike’s Information Criteria. Chi-square test of association and the inter-class correlation (ICC) are used to test and compute the variation of fetal macrosomia among the regions, respectively.Results: The overall prevalence of fetal macrosomia among the weighted infants at birth is 219 (10.4%). Based on the estimated chi-square test, there is a significant difference in fetal macrosomia across the regions of Ethiopia. The ICC reveals that 14% of the variation in fetal macrosomia can be explained by grouping the infants into the regions. Random intercept with fixed slope model fits the study data well as compared to the other competitors. Based on this model, the age of the mother, residence, educational level of mother, body mass index of mother, gestational age, wealth index, multiple pregnancies, and the infant sex are the significant factors associated with fetal macrosomia in all regions of Ethiopia.Conclusion: Concerned bodies, including the ministry of health and its hierarchical body, need to give special support and attention to women aged between 35 and 49, post-term pregnant women, and overweight or obese women to minimize the prevalence of fetal macrosomia.