Neonatal Outcomes of Macrosomic Births in Diabetic and Non-diabetic Women

Objective: To compare the neonatal outcomes and birth injuries of macrosomic infants born to diabetic mothers (IDM) and non-diabetic mothers (non-IDM). Study design: This is a retrospective survey of all live born, singleton neonates with a birth weight of ⩾4000 g, delivered at the Albert Einstein Medical Center, Philadelphia during a 3-year period (2003 through 2005). 305 infants of the 7158 delivered during this period met entry criteria. Data were analysed using χ 2 and Fisher’s exact test. Logistic regression analysis was also performed. Result: Compared to IDMs, non-IDMs were born later (40 vs 38 weeks) and were more likely to be delivered vaginally (70% vs 34%). Half of the non-IDMs (49.6%) had at least one morbidity compared with 73.2% of the IDMs. Non-IDMs had a higher incidence of birth injury than IDMs (8% vs 2.4%). Logistic regression showed an increased risk of poor outcome with weight ⩾4500 g and vaginal delivery. Conclusion: All macrosomic infants represent a high-risk group, regardless of maternal diabetes status.