Birth weight is anessential indicator for assessing child health in terms of early exposure to childhoodmorbidity and mortality. Described as a newborn with an excessive birth weight,fetal macrosomia has become one of the major public health concern because of itsincreased risks for both mothers and infants 12.The neonate is considered to bemacrosomic when its birth weight is greater than 4000-4500 g or greater than90% for gestational age 34. Thus, measuring the birth weight soonafter delivery canbe a fundamental tool for the diagnosis of the fetal macrosomia 5.On one hand, cesareandelivery, labor augmentation with oxytocin, protracted labor, postpartumhemorrhage, infection, 3rd- and 4th-degree perineal tears, and thromboembolicevents are well-known risks that macrosomic newborn poses to the mother 67. On the other hand, birth trauma (shoulderdystocia, brachial plexus injury, skeletal injuries), prenatal asphyxia,hypoglycemia, fetal death as well as increased risks of developing hypertension,obesity, and type 2 diabetes later in life, are the risks of macrosomia ininfants 3.
Several studies have identified potentialrisk factors related to the causation of macrosomia. These include high pre-pregnancyBody Mass Index (BMI), excessive weight gain during pregnancy, gestationaldiabetes and fasting blood glucose, multiparty, male sex, parental height, andprolonged gestation 38.A broadunderstanding of the underlying risk factors is essential to informwell-designed preventive and management efforts.
In Malawi, most efforts havebeen concentrated on under-nutrition as well as low birthweight in childrenunder the age five. However, fetal macrosomia has received no attention despiteits detrimental effects on childhood health outcomes. According to the MalawiDemographic and Health Survey (MDHS), Four percent of births are reported asvery small, 12% as smaller than average, and 83% as average as or larger thanaverage 9. Thus, we aimed to investigate thefactors associated with fetal macrosomia.