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A prospective study on some factors which influence the delivery of large babies.

Lawoyin TO. J Trop Med Hyg. 1993.


Data on a total of 492 randomly selected women who delivered at term (37-41 weeks) singleton babies in the facilities are analysed. These mothers had been followed up regularly from the booking clinic till delivery of their babies. There were 51 (10.4%) large babies with birth weight > or = 3800 g. Of these, 30 were males and 21 were females. The mean weight of the males, 4005 +/- 0.188 g, was significantly higher than that for females, 3978 +/- 0.197 g. There was a significantly increased risk of Caesarean section in the large babies compared with the controls with birth weight < 3800 g born in the same period. There was a maternal death during the delivery of one of the large babies by Caesarean section. The mean total maternal weight gained for birth weight 3800-4000 g was 14.33 +/- 3.82 kg and for babies weighing over 4000 g was 20.36 +/- 2.6 kg, significantly higher than the controls (P < 0.001). Maternal weight gain, maternal height, season of delivery and maternal ponderal index at delivery were significantly related to the birth of large babies (P < 0.001). Parity was also significantly related (P < 0.01). Maternal education and socio-economic class were not (P > 0.5). No diabetic mother was included in the analysis.


In India, physicians followed 492 pregnant women attending the prenatal clinics at the 4 city hospitals in Ibadan to examine factors that effect the delivery of infants large for gestational age. None of the women had diabetes mellitus. 10.4% of the women delivered large infants (or= 3800 g). A higher proportion of large infants were born after the rainy season and the harvest season than at other times (15.5% vs. 8.5-10.3%), perhaps due to more variety of and a larger amount of food available at reasonable cost. Large infants were more likely to be delivered via cesarean section than normal weight and low birth weight (LBW) infants (17.6% vs. 4.5% and 9.8%, respectively; p .001). No large infants were stillborn. The stillbirth rate increased as birth weight decreased (0.75% for 2501-3799 g and 4.9% for LBW infants; p .0001). This suggests that large infants are stronger and better equipped to bear the trauma of childbirth. The more weight mothers gained, the greater the incidence of large infants (0 large infants for mothers gaining 0-10 kg, 14.3% for those gaining 10.1-1-15 kg, 21% for those gaining 15.1-20 kgs, and 40% for those gaining 20.1-25 kg; p .001). Maternal height and maternal ponderal index (maternal weight at delivery [kg]/height squared [sq. m]) had a significant positive association with large infants p (p .001 and .0001, respectively). The likelihood of large infants increased with parity (e.g. mothers with large infants, 8.3% for 0 parity vs. 26.5% for parity 6; p .01). Neither maternal education nor socioeconomic class were linked to large infants. These findings demonstrate a need for providers in Nigeria to pay more attention to mothers who gain more than 15 kg in pregnancy, taller mothers, high-parity mothers (- or parity 3), mothers with a high ponderal index, and mothers delivering immediately after the rainy season.


8254713 [PubMed - indexed for MEDLINE]
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