OBJECTIVE: Our purpose was to assess the efficacy of routine ultrasonographic prediction of macrosomic fetal weight, to determine its influences on subsequent delivery type and to assess perinatal outcome by delivery type. METHODS: The hospital records of 177 patients delivered infants weighing > or =4000gm between January 1997 and December 1998 were reviewed. Statistical comparisons were made between patients in whom fetal macrosomia was predicted before delivery(n=71) and those in whom it was not(n=106) and between the perinatal outcomes for macrosomic fetuses delivered vaginally and by cesarean section. The statistical analysis was performed by student-t test, and Chi-square test and Fisher's exact test. RESULTS: The fetuses were consecutive singleton fetuses in vertex presentation delivered at a single institute. The sensitivity for identifying macrosomic fetus(birth weight >4000gm) with an estimated weight of > or =4000gm was 40%, Overall 60% of the infants had birth weights within 10% of the ultrasonographic estimates and 29% had birth weights within 5% of the ultrasonographic estimates. Cesarean sections were performed in 69% of the 'predicted' group and in 35% of the 'not predicted' group(69% vs 35%, p<0.0001, Fisher's exact test). Predicated group were more likely to be performed by elective cesarean section(48% vs 19%, p<0.0001, Fisher's exact test) and more like due to failed progress at<4cm cervical dilatation(27% vs 7%, p<0.05, Fisher's exact test). The proportion of patients delivered by cesarean section for failed progress at > or =4cm cervical dilatation was similar in the predicted and not predicted groups(19% vs 12%, NS). There was no significant difference in the incidences of the occurrence of birth trauma. CONCLUSION: There appears to be a limitation to obtain estimation of fetal weight by ultrasonography. The antenatal prediction of fetal macrosomia is associated with a marked increase in cesarean deliveries without a significant reduction in the incidence of fetal injury
Birth Weight ; Cesarean Section ; Female ; Fetal Macrosomia ; Fetal Weight* ; Fetus ; Hospital Records ; Humans ; Incidence ; Infant ; Labor Stage, First ; Parturition ; Pregnancy ; Ultrasonography*

OBJECTIVE: Macrosomia is associated with increased birth injury and neonatal morbidity as well as a higher rate of cesarean delivery. Our purpose was to determine whether induction of labor after sonographic diagnosis of fetal macrosomia could improve maternal and neonatal outcome. STUDY DESIGN: The hospital records of 180 patients who delivered of an inFant with birth weight over 4000 gm were reviewed. The subjects were divided into three groups based on obstetric management as follows.. expectant management after sonographic diagnosis of fetal macrosomia(group I), induction of labor(group lI), unexpected patients who were underestimated of fetal weight(estimated fetal weight<90th percentile) (groupIII), Patients who underwent elective cesarean delivery and complicated with diabetes were excluded. Outcome variables for comparison in three groups were mode of delivery, 5 minute Apgar score below 7, presence of cephalohematoma, clavicular fracture, brachial plexus injury, and intraventricular hemorrhage. RESULTS: One hundred eighty patients who eligible for the study, of whom 32 patients were included to group I, 57 patients to group lI, and 91 patients to group Ill, respectively. The cesarean rate within elective induction group was 49%, which was significant higher than the 16% rate in expectant management group and 19% in unexpected group(p<0.05). The observed rates of cephalohematoma, clavicular fracture and 5 min Apgar score below 7 were not significantly different in three groups. CONCLUSIONS: There was an significant increased cesarean delivery rate without improvement in neonatal outcomes or reduction in birth injury among pregnancies in which labor was electively induced after sonographic diagnosis of fetal macrosomia. Elective induction of labor should be discharged in cases with fetal macrosomia.
Apgar Score ; Birth Injuries ; Birth Weight ; Brachial Plexus ; Diagnosis* ; Female ; Fetal Macrosomia* ; Hemorrhage ; Hospital Records ; Humans ; Infant ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Ultrasonography*

PURPOSE: The authors analyzed the trend from the birth-related statistics of high birth weight infants (HBWIs) over 50 years in Korea from 1960 to 2010. METHODS: We used 2 data sources, namely, the hospital units (1960's to 1990's) and Statistics Korea (1993 to 2010). The analyses include the incidence of HBWIs, birth weight distribution, sex ratio, and the relationship of HBWI to maternal age. RESULTS: The hospital unit data indicated the incidence of HBWI as 3 to 7% in the 1960's and 1970's and 4 to 7% in the 1980's and 1990's. Data from Statistics Korea indicated the percentages of HBWIs among total live births decreased over the years: 6.7% (1993), 6.3% (1995), 5.1% (2000), 4.5% (2000), and 3.5% (2010). In HBWIs, the birth weight rages and percentage of incidence in infants' were 4.0 to 4.4 kg (90.3%), 4.5 to 4.9 kg (8.8%), 5.0 to 5.4 kg (0.8%), 5.5 to 5.9 kg (0.1%), and >6.0 kg (0.0%) in 2000 but were 92.2%, 7.2%, 0.6%, 0.0%, and 0.0% in 2009. The male to female ratio of HBWIs was 1.89 in 1993 and 1.84 in 2010. In 2010, the mother's age distribution correlated with low (4.9%), normal (91.0%), and high birth weights (3.6%): an increase in mother's age resulted in an increase in the frequency of low birth weight infants (LBWIs) and HBWIs. CONCLUSION: The incidence of HBWIs for the past 50 years has been dropping in Korea. The older the mother, the higher was the risk of a HBWI and LBWI. We hope that these findings would be utilized as basic data that will aid those managing HBWIs.
Age Distribution ; Birth Weight ; Information Storage and Retrieval ; Female ; Fetal Macrosomia ; Hospital Units ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Live Birth ; Male ; Mothers ; Parturition ; Rage ; Sex Distribution

Maternal nutritional status during pregnancy will affect the outcomes for the mother and the newborn. Maternal diet was assessed in 150 pregnant women during the first trimester of pregnancy by a 168-item food frequency questionnaire. Dietary patterns were explored by Factor analysis, and association of patterns with maternal and neonatal outcomes such as gestational diabetes mellitus (GDM), anemia and anthropometric indices were determined by analysis of variance and linear regression analysis. Three major dietary patterns were identified: 1) High Carbohydrate-Lower Fat (mean age, 27.67 ± 6.1; n = 34), 2) High Carbohydrate-Higher Fat (27.70 ± 4.1; n = 55), and 3) High Fiber (29.27 ± 5.8; n = 61). A significant difference was observed between maternal dietary patterns (p < 0.01) for GDM, while it was not significant for anemia. Also, the number of preterm and low birth weight (LBM) infants as well as mean weight, height and head circumference of the infants did not differ significantly between patterns, but there was a significant difference between the maternal dietary patterns about the number of macrosomic babies, which was higher in the second (n = 9) and third (n = 9) dietary patterns (p < 0.01). After adjusting for mothers' age, disease history, disease status, and energy intake, High Carbohydrate-Lower Fat dietary pattern was more associated with GDM than crude model (p = 0.01 vs. p = 0.02). The present study indicated a significant relationship between maternal dietary patterns before pregnancy and GDM and fetal macrosomia.
Anemia ; Birth Weight ; Diabetes, Gestational ; Diet ; Energy Intake ; Female ; Fetal Macrosomia ; Food Habits ; Head ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Linear Models ; Mothers ; Nutritional Status ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women

OBJECTIVE: Under the definition of macrosomia where the birth weight of the fetus being 4,000 grams or more, we analyzed and studied the obstetrical problems, complications of both mother and the fetus and the predisposing factors of macrosomia in this report. METHODS: A study was done on 231 cases of macrosomia infants weighing 4,000 grams or more out of 5220 full-term delivered cases in Dongguk University, Kyung-ju hospital from January, 1998 to December, 2002. RESULTS: The frequency of macrosomia ranged from 4.18% in 4,000 g or more to 0.42% in 4,500 g or more. In macrosomia frequency correlations to parity showed 41.13% (95 cases) in primiparous women, 58.87% (134 cases) in multiparous women. According to the type of delivery, normal vaginal delivery has proven to be the most, consuming 52.38% (121 cases), where Cesarean section was 47.61% (110 cases). Indications for Cesarean section ranged from cephalopelvic disproportion (27.3%) to previous Cesarean section (25.4%), in the order of frequency. Maternal complications due to delivery showed highest incidence in postpartum hemorrhage (13.63%), followed by birth canal laceration (12.12%). As of fetal complications, 3 cases (2.72%) of cephalhematoma existed, and 1 brachial plexus palsy and clavicle fracture were reported and 1 case of fetal death was reported. CONCLUSION: It would be appropriate to have definite diagnostic schemes and adequate choice of delivery method for macrosomia. Therefore, the complications of macrosomia could be decreased by a well-trained delivery coming in forehand.
Birth Weight ; Brachial Plexus ; Causality ; Cephalopelvic Disproportion ; Cesarean Section ; Clavicle ; Female ; Fetal Death ; Fetal Macrosomia* ; Fetus ; Gyeongsangbuk-do ; Humans ; Incidence ; Infant ; Lacerations ; Mothers ; Paralysis ; Parity ; Parturition ; Postpartum Hemorrhage ; Pregnancy

OBJECTIVE: Under the definition of macrosomia where the birth weight of the fetus being 4,000 grams or more, we analyzed and studied the obstetrical problems, complications of both mother and the fetus and the predisposing factors of macrosomia in this report. METHODS: A study was done on 231 cases of macrosomia infants weighing 4,000 grams or more out of 5220 full-term delivered cases in Dongguk University, Kyung-ju hospital from January, 1998 to December, 2002. RESULTS: The frequency of macrosomia ranged from 4.18% in 4,000 g or more to 0.42% in 4,500 g or more. In macrosomia frequency correlations to parity showed 41.13% (95 cases) in primiparous women, 58.87% (134 cases) in multiparous women. According to the type of delivery, normal vaginal delivery has proven to be the most, consuming 52.38% (121 cases), where Cesarean section was 47.61% (110 cases). Indications for Cesarean section ranged from cephalopelvic disproportion (27.3%) to previous Cesarean section (25.4%), in the order of frequency. Maternal complications due to delivery showed highest incidence in postpartum hemorrhage (13.63%), followed by birth canal laceration (12.12%). As of fetal complications, 3 cases (2.72%) of cephalhematoma existed, and 1 brachial plexus palsy and clavicle fracture were reported and 1 case of fetal death was reported. CONCLUSION: It would be appropriate to have definite diagnostic schemes and adequate choice of delivery method for macrosomia. Therefore, the complications of macrosomia could be decreased by a well-trained delivery coming in forehand.
Birth Weight ; Brachial Plexus ; Causality ; Cephalopelvic Disproportion ; Cesarean Section ; Clavicle ; Female ; Fetal Death ; Fetal Macrosomia* ; Fetus ; Gyeongsangbuk-do ; Humans ; Incidence ; Infant ; Lacerations ; Mothers ; Paralysis ; Parity ; Parturition ; Postpartum Hemorrhage ; Pregnancy

No abstract available.
Fetal Macrosomia*

No abstract available.
Birth Weight* ; Leukocytes* ; Parturition* ; Zinc*

Among premature and low birth weight infants admitted between March 1970 and February 1977, 228 infants who were clinically normal and older than 7 hospital days are evaluated as to the changes of baby weight. The average postnatal weight loss was 18 to 8 per cent during the first 7 to 17 days after birth. Infants refained their birth weight at the age of 15 to 17 days in the weight group of 1001 to 1250g 9 to 10 days in 1251 to 1500g, 13 to 15 days in 1501 to 1750g, 14 to 16 days on 1751 to 2000g, 11 to 13 days in 2001 to 2250g, 7 to 8 days in 2251 to 2500g. Postnatal weight gain in this study corresponded well to Dancis postnatal growth curve.
Birth Weight ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Parturition ; Weight Gain ; Weight Loss

Among premature and low birth weight infants admitted between March 1970 and February 1977, 228 infants who were clinically normal and older than 7 hospital days are evaluated as to the changes of baby weight. The average postnatal weight loss was 18 to 8 per cent during the first 7 to 17 days after birth. Infants refained their birth weight at the age of 15 to 17 days in the weight group of 1001 to 1250g 9 to 10 days in 1251 to 1500g, 13 to 15 days in 1501 to 1750g, 14 to 16 days on 1751 to 2000g, 11 to 13 days in 2001 to 2250g, 7 to 8 days in 2251 to 2500g. Postnatal weight gain in this study corresponded well to Dancis postnatal growth curve.
Birth Weight ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Parturition ; Weight Gain ; Weight Loss