جستجوی مقالات مرتبط با کلیدواژه « ماکروزومی » در نشریات گروه « پزشکی »

Macrosomia is a common complication in obstetrics and gynecology and its complications usually expose mother and fetus at risk. The aim of the present study was to evaluate the prevalence rate of macrosomia and related risk factors in pregnant women in Bojnourd.

This descriptive analytic study was performed on 7908 pregnant women referred to Bentolhoda Hospital. Mothers with macrosomic infant were selected as case and the same number of women with term and normal delivery were selected as control groups. Data was analyzed by SPSS 24 software.

Maternal mean age, weight gain and duration of pregnancy were significantly increased among macrosomia group. Previous history of macrosomic infant and maternal hyperglycemia was directly related to increased risk of macrosomia. We did not find correlation between macrosomia and increased risk of neonatal malformations, shoulder dystocia, clavicle fractures, brachial plexus damage and maternal complication after delivery and increased cesarean section.

Due to 2.41% macrosomia frequency in Bojnourd city and its significant relationship with risk factors such as maternal age, mean pregnancy weight gain and pregnancy duration, maternal diabetes and macrosomic birth history, appropriate planning for pregnancy and Entering a well-weighted pregnancy and enjoying a varied and healthy diet will help maintain and promote maternal and neonatal health in the normal weight range.

Gestational diabetes can leads to macrosomy, fetal abnormalities, increase prevalence of hypertension, increasing unreasonable morality. Diet plays a very important role in the consequences of pregnancy in these patients. The purpose of this study was to assess the effect of diet based on body mass index (BMI) on pregnancy outcomes in diabetic pregnant 20-35 year old women referring to Arash hospital.
In this randomized double-blind clinical trial, 70 diabetic pregnant women 20-35 year old were divided in two groups as case and control. Control group was on diet with 30 kilo calorie per kilogram energy without consideration BMI. In this way, The case group, with BMI 19-24.9 got 30 kilo calorie per kilogram energy and with BMI 25-29.9 got 25 kilo calorie per kilogram energy. SPSS version 23 software was used for analyzing and (P There was no significant difference between case and control group about mean of increasing weight end of pregnancy (p=0.3), The birth weight (p=0.05), Insulin requirement (p=0.7), macrosomia (p=0.2), hypertension (p=0.1), intra uterine growth retardation (p=0.3), gestational age in delivery (p=0.3), infant blood calcium (p=0.3) but infant blood sugar in case group was less than control group significantly (p=0.01).
Calorie restriction based on BMI in case group compared to control group was not effective about more pregnancy outcomes such as average weight gain at the end of pregnancy, Insulin requirement, weight of newborns at birth, macrosomia baby birth, Having high blood pressure, intra uterine growth retardation, gestational age in delivery, infant blood calcium. but infant blood sugar in case group was less than control group significantly.

Macrosomia is a risk factor for adverse delivery outcomes. The aim of this study was to determine the rate of macrosomia among singleton life-birth, and identify factors associated with it.
This cross-sectional study was conducted on 4342 pregnant women who gave singleton live-birth in Tehran province, Iran, during 6-21 July 2015. Data were collected using a researcher-made questionnaire through interview with mothers and review of their medical records. To identify factor associated with macrosomia, logistic regression model was used.
Findings: The macrosomia rate was 3.4% in this study. In univariate analysis, higher maternal age, height, body mass index, gestational age, birth order and history of stillbirth and male infant sex were associated with macrosomia. Moreover, multivariate analysis showed a significant relationship between macrosomia and higher height, body mass index, gestational age, birth order and male infant sex.
According to the results, factors such as mother’s age, height, body mass index, and gestational age, birth order and male infant sex were associated with macrosomia. Considering these factors could be effective in determining at-risk neonates and reducing maternal-infant side-effects of macrosomia.

In addition to adequate nutrition and balance of nutrients in the pregnant mother's diet, maternal weight gain during pregnancy has a major impact on maternal health and fetal well-being. The purpose of this study was to compare pre-gestational BMI and gestational weight gain on GDM according to the new definition of GDM. This descriptive cross-sectional study was carried out on 18 to 35 years old pregnant women with no underlying disease using convenience sampling method In the first months of pregnancy, women's height, weight and blood pressure as well as FBS were measured.The second assessment was done in the 24th-28th weeks of gestation using repeated measurements of weight, blood pressure, and gestational diabetes screening test (GCT). The third evaluation was conducted at the end of pregnancy to measure mother and infant weight.The data was analyzed by SPSS, version 16, t-test and Mann-Whitney test. In this study, 600pregnant women were evaluated.Mean BMI befor pregnancy in the women with GDM was significantly higher than in the women without the above-mentioned problems(P=0.0001). The mean weight gained during pregnancy in the women with these symptoms was significantly higher than that in the women without the above –mentioned problems(P=0.039)(P=0.0001). Compared to pre-pregnancy BMI, weight gain during pregnancy had a higher with GDM(0.278 vs 0.077). Pre-pregnancy BMI in comparison with weight gain during pregnancy, had a higher correlation with GDM and macrosomia

Birth weight is one of the major factors determining the physical and mental development of infants and a credible sign of intrauterine growth. The purpose of this study was to investigate factors associated with macrosomia and low birth weight in women referred to delivery room of Specialized Hospital in 2010.

In this cross sectional study, 3076 women with the normal vaginal delivery (NVD) entered into the study population. The Statistical Package for the Social Sciences, SPSS 17 for Windows, was used for the analysis. Data analysis was performed by using descriptive and analytical statistics (mean ±SD), Chi-square test, independent sample t- test, ANOVA, post hoc scheffe and linear regression). The significant level was set at less than 0.05 (P < 0.05).

The prevalence rate of low birth weight was 6.7% (205) and macrosomia 3.2% (97). Average neonatal birth weight was 3248.18 ± 458gr and maternal age was 25.33 ± 5.7 years. On the basis of linear regression, types and number of delivery, neonatal sex, preeclampsia and age of mother were respectively the most important factors of low birth weight. None of them related to macrosomia.

Our findings showed that we can decrease the prevalence of low birth weight and macrosomia which result in normal birth weight by detection and controlling of many factors related to the birth weight.

Macrosomia is a term applied to newborns with a birth weight more than of 4000 gr which cause different maternal and neonatal complications. Several risk factors has been known for macrosomia. The purpose of this cross-sectional study was to estimate the frequency and evaluate of risk factors of macrosomia in Asalian hospital of Khorramabad in 2010. This study was undertaken in Khorramabad, Iran. The data collection instrument was a questionnaire containing 10 variables as the risk factors of macrosomia. The data were analyzed using the SPSS software. 59 cases of macrosomia were found in 500 living births, and the frequency of macrosomia was 11.8%. Also, 69.5% of the neonates were male and 30.5% were female. Maternal risk factors were mother''s age at pregnancy, mother''s obesity (BMI>=30), weight gain more than 18 kg during pregnancy, history of diabetes mellitus, history of macrosomia, prolonged gestational age, and multiparity (parity>=5). There was no significant relationship between mother''s job and macrosomia. The prevalence of macrosomia in Khorramabad was high (11.8%). Preventing pregnancy in mothers over 35 years of age by contraception ways, preventing maternal obesity before pregnancy, and control of blood glucose during pregnancy by suitable diet and insulin therapy are recommended to prevent macrosomia.

Neonatal macrosomia، hypoglycemia، and hypocalcemia are among the complications associated with gestational diabetes. The aim of this study was to compare the frequency of neonatal hypoglycemia and hypocalcemia in macrosomic and non macrosomic infants of diabetic mothers. This was a descriptive analytic study performed on 90 infants born to diabetic mothers in Javaheri hospital during 2005 - 2009. Blood glucose level was determined for all infants during the first 3 hour، between 3-24 hour، and 24 hours after birth. Blood calcium concentration was also measured within the first 3 hour and 24 hours after birth. Data were analyzed by chi square and Fisher exact tests. Of 90 infants، 33. 3% were macrosomic. Hypoglycemia and hypocalcemia were more common in macrosomic infants of diabetic mothers compared to non macrosomic neonates.

Pelvic organ prolapse is a common disorder among women. More than half of the women، who have given birth، may experience it during their life. The aim of this study was to investigate the relationship between birth weight and prevalence and severity of pelvic organ prolapse. In a cross-sectional study، 365 of women who referred to Health centers in Darre shahr city of Ilam were randomly entered to this study. The data were collected by using questionnaire، recording examination، interview، and observation. Examinations were performed based on Pelvic Organ Prolapse Quantification (POPQ). The statistical analysis was performed by SPSS software Version 14 and Chi-square test. Descriptive statistics tests were used to determine the frequencies and Means. P value less than 0. 05 was considered significant. Of all 365 participated women، 19. 2% without prolapse and 80. 8% had different degrees of prolapsed. The most types of prolapse included grade two (56. 8%) and anterior wall (72. 3%). According to Mann-Whitney test، there was a significant relation between pelvic organ prolapses and maximum birth weight of newborns (P= 0. 011). Pelvic organ prolapsed was common and had relation with birth weight of neonates.

Recent studies have reported that high and low maternal pre-pregnancy weight is accompanied with adverse pregnancy outcome including preterm labor and low birth weight or macrosomia. The purpose of the present study is to find the relationship between maternal pre-pregnancy body mass index (BMI) and spontaneous preterm labor and birth weight. This cohort study was performed on 576 pregnant women who referred to Shahid Akbarabadi hospital in Tehran in year 2008. 396 women finally finished the study. Maternal BMI was determined at the first prenatal visit (between 8-12 weeks of pregnancy) then the women were followed up to delivery. Gestational age at the time of delivery and neonatal weight were recorded and their results were investigated in four groups: underweight (BMI<20 kg/m2)، normal weight (BMI=20-24. 9 kg/m2)، over weight (BMI=25-29. 9 kg/m2) and obese (BMI=30-40 kg/m2). Data were analyzed using SPSS software (version 15)، T-test، ANOVA، Chi-square and Pearson correlation tests and linear regression model. P less than 0. 05 was considered statistically significant. The women in all BMI groups had no significant differences according to age، height، history of abortion and occupation. 21 women (5. 3%) were underweight، 198 women (50%) had normal weight، 117 women (29. 5%) were overweight and 60 (15. 2%) were obese. No case of morbidly obese was seen. Obesity had positive correlation with higher gestational age at the time of delivery (r=0. 213، p=0. 015) and more birth weight (r=0. 361، p=0. 008). In contrast، low birth weight had correlation with low maternal weight (r=0. 157، p=0. 041). Macrosomia was more in obese women (p=0. 022) and BMI had positive correlation with macrosomia (r=0. 224، p=0. 034). Preterm labor showed a negative correlation with BMI (r=-0. 124، p=0. 004) and preterm labor was seen more in women with lower BMI (p=0. 035). Overweight women was more high risk for macrosomia، while، low birth weight (LBW) and spontaneous preterm labor were seen more in underweight mothers.

Gestational diabetes mellitus (GDM) is a common complication of pregnancy that is associated with fetal and maternal adverse outcomes. These women are at higher risk for development of type 2 diabetes mellitus (T2DM) and metabolic and cardiovascular disease. Various results have been presented on the long term consequences of GDM. We aimed to compare the incidence of these metabolic disorders between women with previous GDM and those without any history of GDM. Three groups of non-diabetic women, aged 15-45 y who participated in first phase of Tehran Lipid and Glucose Study (TLGS) were selected; 1) women with previous GDM, 2) women with previous still birth or macrosomia and without any history of GDM, and 3) normal age-BMI matched controls. They were followed for an average of 9 years, for developing of type 2 diabetes mellitus, hypertension and dislipidemia. Cumulative incidence of T2DM in the GDM group was 3-fold higher than the control. Incidence rates of T2DM were not significantly different between women in MC-ST group and their controls; however the serum concentrations of FBS were significantly different between these two groups. There was no significant difference in the cumulative incidence of hypertension and dislipidemia between the case and control groups. Women with previous GDM are at an increased risk of developing T2DM later in life. It seems that GDM screening in pregnancy could identify women at risk of metabolic disease.

Diabetes, especially the gestational diabetes with its special fetal and maternal disorders, is the most common complication of pregnancy. Both gestational and type II diabetes mellitus are along with a disturbances to insulin secretion as well as insulin resistance. Considering the significant role of zinc in insulin function, the deficiency and importance of this element in gestational diabetes is a matter of consideration. This clinical trial was carried out on 60 pregnants suffering from gestational diabetes, and needing insulin injection from 32nd week to full-term. The patients were divided into two groups the case group (n=30), received daily zinc sulfate (25mg or 5cc) plus insulin and control group (n=30) received daily placebo (5 cc as syrup) plus insulin until the time of delivery. The required insulin dose was regulated through monitoring fasting blood sugar and blood sugar, 2 h postprandial, every two weeks in both groups. These groups were compared in terms of required insulin dose and maternal/fetal complications. Data were analyzed using t-test, OR, CI, Fisher Exact test, Kolmogorov-Smirnov and Chi-Square tests. The required dose of insulin had a significant decrease in the case group compared to the control one (p<0.001). However, the mean change in insulin dose in the case and control group compared to the beginning of study was 8.766 (SD:9.63) and 17.533 (SD: 10.54), respectively. The incidence of macrosomia in the case and control groups was significant (P<0.01). The odds ratio of control group compared to the case group was 7. The preeclampsia prevalence in both groups was not significant. Zinc supplementation in gestational diabetes may lead to the reduction of required insulin dose, incidence of macrosomia and the related complications (e.g., caesarian and delivery dystocia).

Macrosomia is a term applied to newborns with a birth weight of >4000g. This condition leads to several maternal and fetal complications including maternal traumas as well as newborn injury. This study was designed to evaluate the risk factors of macrosomia among Iranian women. This cross-sectional study performed between July 2001 and July 2002, included 2000 term deliveries involving newborns with birth weights of >2500g. The records of 77 mothers of live born infants weighing >4000g were compared to those of the control group (231 women). Stillborn and neonates who were <2500g were excluded from the study.

Fetal hyperinsulinemia correlated with large birth weight and impaired glucose tolerance test and obesity in second decades of life. In this study we compared the correlation between fetal insulin production (as estimated by amniotic fluid (AF) C-peptide concentration) and AF insulin with macrosomia (as estimated by neonatal birth weight 4000 gr). Thirty eight neonates were studied. Ten infants were macrosom and 28 were normal (birth weight < 4000 gr). Amniontic fluid C-peptide and insulin concentration and mother and fetal blood C-peptide and insulin were measured during delivery with radioimmunoassay and mother and fetal glucose were measured at the same time and correlated with neonatal macrosomia within first hour of birth. There was a significant correlation between infant serum C-peptide level and macrosomia. Amniotic fluid insulin level was higher in the macrosom infants but this correlation was not significant. AF C-peptide was higher in the macrosom group. Also there was a significant correlation between maternal serum C-peptide and macrosomia. Infant and mother serum insulin was higher in the macrosom group. Our results suggest that fetal insulin (as estimated by AF C- peptide) and mother insulin and C- peptide production, can influence fetal weight and induce fetal macrosomia.

Accurate estimated fetal weight (EFW) has importance in the management of labor and delivery. Estimated fetal weight was done in two sonographic and clinical ways (Palpation of abdomen). Many studies have been conducted for comparing clinical and sonographic EFW. With regard to contraindications and absence of studies in this area, this research was conducted on women admitted due to termination of pregnancy in Shabih Khani Maternity Hospital in 1383 This research as a cross-sectional study was done on 100 women with gestational 37/42-week ages admitted for termination of pregnancy. Excluded criteria consists of premature rupture of membrane, placenta abruption- placenta previa, preeclampsia, fetal abnormality, amniotic fluid disorder Clinical estimation in labor was performed by senior resident or obstetrician and sonographic estimation was performed by sonographists. The actual birth weight was determined by electronic scales and recorded in the chart immediately after delivery. Accuracy of birth weight estimation was determined by calculating the percentage error, and the proportion of estimates within 10% of the actual birth weight. Then processing of information performed by chi-square, fisher exact test and relative risk was determined study on 100 pregnant woman showed mean age was 22.5 ± 4.5 and mean gestational age was. 39.2 ± 0.9 and mean birth weight was 3513 ± 370.3. Birth weight in %10 of new born was less than 3000 gr and %12 of birth weight was more than 4000 gr. In total pregnant women clinical estimation in (83 women) 83% and sonographic estimation in (67 women) 67% was acceptable in which statically were important (P= 0.009).In birth weight less than 3000 gr sonographic estimate better than clinical estimate p<0, 03 regarding that most of fetus is reneged between 3000-4000 gr. accuracy of clinical estimation is often more than sonographic estimation so that we can perform EFW by simple weight and without cost. But in cases such as low birth weight that sonographic estimation of weight as direct diagnosis are defined and in obese women due to difficulty of clinical estimation, we suggest sonographic estimation to use.

The objective of the present cross-sectional study was to evaluate the risk factors for gestational diabetes mellitus. A case-control study was performed on 62 pregnant women with gestational diabetes mellitus and 80 normal pregnant women at Firooz Abadi Hospital during 1998 1999. The patients in two groups were compared according to age, parity, pre-pregnancy weight, family history of diabetes mellitus, history of macrosomia in their previous pregnancies, history of hypertension, previous malformed fetus, history of IUFD and abortion. Based on the obtained results there was a statistically significant difference between two groups in terms of age (P<0.0002), parity(P<0.0001), pre-pergnancy weight (P<0.0001), family history of diabetes mellitus (P 0.0002),previous macrosomia (P<0.0004), history of hypertension (P<0.0002), previousmalformed fetus(P<0.0003) and previous IUFD (P<0.0002), but abortion was notsignificantlydifferent.Older age,parity (3 or more) obesity, family history of diabetes mellitus, history of macrosomia, hypertension, malformed fetus and also previous IUFD are risk factors for gestational diabetes. Therefore, these women should be screened and handled for gestational diabetes in their pregnancies, and controlled for possible diabetes mellitus in the future.

Background and Macrosomia can increase maternal & neonatal complications.These complications and their relevance to macrosomia was evaluated in this study. This was a cohort study done, by selecting 5440 delivery files, in which 4400 cases had natural delivery and 104 patients with cesarean section. Patients with full term delivery of neonate with 4000 grams were selected as a case group and the patients with full term delivery of neonate with 25000-3999 grams weight were selected as a control group. Factors like, parity, and delivery status were the same for both groups, the patients with repeated cesarean were omitted in this study. The results of this study showed that the total rate of cesarean section in control group was 15.5% against the rate of 11.5% in control group (P<0.037), and the main reason of cesarean in macrosomic group was due to fetal distress. Shoulder dystocia and excretion of moconium was the only complication of Macrosomic infants, which showed no statistically significant difference (P<0.002), post delivery bleeding and administration of oxytocin for acceleration of labour in case groups showed no significant difference with cantrol groups (P<0.01). This study indicated that, despite high rate of vaginal delivery, of macrosomic infant, excluding shoulder dystocia, delivery of macrosomia and post delivery bleeding, there was no significant difference in maternal complications and further study is recemmonded in such type of deliveries.