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ObjectiveThe objective of the study was to examine the birthweight at which risks of perinatal death, neonatal morbidity, and cesarean delivery begin to rise and the causes and timing (antenatal, early or late neonatal, or postneonatal) of these risks. Study DesignThis was a cohort study based on 1999-2001 US-linked stillbirth, live birth, and infant death records. Singletons weighing 2500 g or larger born to white non-Hispanic mothers at 37-44 weeks of gestation were selected (n = 5,983,409). ResultsInfants with birthweights from 4000 to 4499 g were not at increased risk of mortality or morbidity vs those at 3500-3999 g, whereas those 4500-4999 g had significantly increased risks of stillbirth, neonatal mortality (especially because of birth asphyxia), birth injury, neonatal asphyxia, meconium aspiration, and cesarean delivery. Births at 5000 g or larger had even higher risks, including risk of sudden infant death syndrome. ConclusionBirthweight greater than 4500 g, and especially greater than 5000 g, is associated with increased risks of perinatal and infant mortality and morbidity. a Department of Pediatrics, McGill University Faculty of Medicine, Montreal, QC, Canada b Department of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada. Cite this article as: Zhang X, Decker A, Platt RW, et al. How big is too big? The perinatal consequences of fetal macrosomia. Am J Obstet Gynecol 2008;198:517.e1-517.e6. Reprints not available from the authors. This study was supported by a grant from the Canadian Institutes of Health Research. R.W.P. is a Monat-McPherson Career Investigator of McGill University and a career investigator (chercheur-boursier) of the Fonds de la recherche en santé du Québec. PII: S0002-9378(07)02270-3 doi:10.1016/j.ajog.2007.12.005 © 2008 Mosby, Inc. All rights reserved.
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ABSTRACT
How big is too big? The perinatal consequences of fetal macrosomia
Perinatal consequences of fetal macrosomia: Zhang et al