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Published Online First: 15 June 2009. doi:10.1136/adc.2008.156026
Archives of Disease in Childhood - Fetal and Neonatal Edition 2009;94:F419-F422
Copyright © 2009 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

ORIGINAL ARTICLES

Neonatal outcomes of macrosomic births in diabetic and non-diabetic women

S Das, M Irigoyen, M B Patterson, A Salvador, D L Schutzman

Department of Pediatrics, Division of Neonatology, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA

Correspondence to Dr David L Schutzman, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA; schutzmand{at}einstein.edu

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 >=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 >=4500 g and vaginal delivery.

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


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