Neonatal Outcomes of Macrosomic Births in Diabetic and Non-diabetic Women

Objective: To compare the neonatal outcomes and birth injuries of macrosomic infants born to diabetic mothers (IDM) and non-diabetic mothers (non-IDM).

Study Design: This is a retrospective survey of all live born, singleton neonates with a birth weight of > or = 4000 g, delivered at the Albert Einstein Medical Center, Philadelphia during a 3-year period (2003 through 2005). 305 infants of the 7158 delivered during this period met entry criteria. Data were analysed using chi(2) and Fisher's exact test. Logistic regression analysis was also performed.

Result: Compared to IDMs, non-IDMs were born later (40 vs 38 weeks) and were more likely to be delivered vaginally (70% vs 34%). Half of the non-IDMs (49.6%) had at least one morbidity compared with 73.2% of the IDMs. Non-IDMs had a higher incidence of birth injury than IDMs (8% vs 2.4%). Logistic regression showed an increased risk of poor outcome with weight > or = 4500 g and vaginal delivery.

Conclusion: All macrosomic infants represent a high-risk group, regardless of maternal diabetes status.