Predictors and pregnancy outcomes associated with a newborn birth weight of 4000 g or more in Lusaka, Zambia

ObjectiveTo identify predictors and outcomes associated with a birth weight of 4000 g or more in Lusaka, Zambia.MethodsData from women who delivered between February 2006 and August 2011 were obtained from electronic perinatal records at 25 public sector facilities in Lusaka. Macrosomia was defined as a birth weight of 4000 g or more and normal birth weight as 2500–3999 g. Maternal and newborn characteristics were analyzed for association with macrosomia.ResultsThere were 4717 macrosomic and 187 117 normal birth weight newborns. The strongest predictors of macrosomia were high BMI (adjusted odds ratio [AOR], 2.88; 95% confidence interval [CI], 1.95–4.24), prior macrosomic newborn (AOR, 7.60; 95% CI, 6.81–8.49), and history of diabetes (AOR, 3.09; 95% CI, 1.36–6.98). Macrosomic newborns were at increased risk for cesarean delivery (AOR, 1.63; 95% CI, 1.35–1.96), fresh stillbirth (AOR, 2.24; 95% CI, 1.56–3.21), Apgar score of under 7 at 5 minutes (AOR, 2.03; 95% CI, 1.33–3.11), and neonatal intensive care admission (AOR, 2.07; 95% CI, 1.32–3.23).ConclusionScreening for macrosomia should be considered for high-risk patients in Sub-Saharan Africa. Institutional delivery at facilities with operating rooms and neonatal intensive care services should be encouraged.