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Prevalence and Clinical Outcome of Neonates with Macrosomia Admitted in the Special Care Baby Unit of the Rivers State University Teaching Hospital, Nigeria

Background: Macrosomia, now an emerging public health problem in the world has significant maternal and neonatal morbidity and mortality. Objectives: To determine the prevalence and clinical outcome of macrosomic babies admitted into the neonatal unit of the Rivers State University Teaching Hospital, Nigeria. Materials and Methods: It was a prospective study carried out from April 2019 to March 2020. Results: There were 1,938 deliveries during the period of study of which 173 weighed ≥4000g giving a prevalence rate of 8.9%. Males predominated 43(59.7%) with a M: F ratio of 1.5: 1 and mode of delivery was majorly via Caesarean section 55(76.4%). Most mothers of macrosomic babies were aged, 27-36 years 46(63.9%) and were mainly multiparous 49(68.6%). The commonest indications of Caesarean section were cephalopelvic disproportion (34.0%), previous Caesarean section (28.3%) and big baby (18.9%) while the commonest morbidities observed were probable sepsis (48.6%), neonatal jaundice (31.9%), difficulty breathing (30.6%) and hypoglycaemia (25.0%). Probable sepsis, difficulty breathing, infants of diabetic mothers and transient tachypnea of the newborn were significantly associated with macrosomia (P<0.05). Neonates with macrosomia were 2times more likely to be infants of diabetic mothers (95% CI: 1.14-4.53) and had 2times the risk of having transient tachypnea of the newborn (95% CI: 1.19-3.46). Sixty-two (86.1%) babies were discharged and 2(2.8%) died. Conclusion: The prevalence of macrosomia is high (8.9%) with male preponderance. A mortality of 2.8% therefore calls for a high index of suspicion during the antenatal and neonatal period so as to reduce both maternal and neonatal morbidity and mortality.