Abstract

Rate of Fetal Macrosomia with Maternal and Early Neonatal Complications in Internally Moved People Affected by Violence

Background: Fetal macrosomia is usually distressing to obstetricians and neonatologists. In the current study, involved mothers had poor social and medical circumstances, as they were migrated forcefully within the country borders due to war, from their original homeland to safer camps which had miserable situations. Objectives: To study rate, risk factors, and complications of macrosomia in people with low socio-economic living conditions and missed medical follow up. Methods: All internally displaced pregnant women who gave birth to neonates weighed ≥4000 g were involved in the study. All required history, examination, care, and investigations were practiced by the attending obstetrician and neonatologist. Cases of normal birth weight neonates from the same sample of internally moved mothers were considered as controls. Results: Fetal macrosomia rate was 15.77% (143 out of 907). Observed significant macrosomia risk factors were maternal age ≥30 years, multiparity, body mass index ≥30, previous or family history of macrosomia, gestational age >40 weeks, cesarean section, diabetes, and hypertension. Meconiumstained liquor, shoulder dystocia, uterine atony, and genital trauma, were major maternal complications, while main neonatal sequelae were Apgar score (>7) at first minute, birth asphyxia, admission to NICU, hypoglycemia, polycythemia, and respiratory distress. Conclusion: Higher rate and more frequently encountered risk factors of macrosomia than national and international figures found in our sample (of forcefully moved mothers) were probably related to poor living circumstances, and absence of regular medical follow up with antenatal care.

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