The objective of this study is to assess commonly used formulae (Sheppard, Campbell, Hadlock I, II, III, and IV) for estimation of fetal weight in Sudanese population. A descriptive cross-sectional study was conducted...The objective of this study is to assess commonly used formulae (Sheppard, Campbell, Hadlock I, II, III, and IV) for estimation of fetal weight in Sudanese population. A descriptive cross-sectional study was conducted at Saudi Hospital-Khartoum-Sudan;from December 2015 to April 2016. The study included 225 singleton pregnancies. The fetal biometry—Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) and actual birth weights (ABW) were taken. Statistical analysis showed significant results at p ≤ 0.005. Results showed that the significant highest positive correlation between the ABW and the EFW/Kg was seen in the Hadlock I, III and IV equations having an equal values (0.951) followed by Hadlock II (0.946), Sheppard (0.872) and lastly Campbell (-0.925) with significant high degree of negative correlation. The new established equation EFW<sub>FLHCAC</sub> is the best formula identified in our study to predict Sudanese babies weight ranged between 1.86 Kg to 3.987 Kg.展开更多
Background: Fetal weight estimation by ultrasound is an important factor in obstetrics;it is directly related to the gestational age which helps to plan the mode of delivery and labor management. Objective: to compare...Background: Fetal weight estimation by ultrasound is an important factor in obstetrics;it is directly related to the gestational age which helps to plan the mode of delivery and labor management. Objective: to compare between fetal thigh circumference (TC) and abdominal subcutaneous tissue thickness (SCT) in estimating birthweight in term pregnant women. Patients and Methods: This prospective cohort study was conducted at outpatient clinic or emergency room, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University Maternity Hospitals from March 2022 until May 2023. During this study, 100 term pregnant females with gestational age 37 - 40 weeks attended El Demerdash Maternity Hospital and scheduled for delivery either at outpatient clinic or emergency room were enrolled, after consenting each of them. Basic fetal biometry was performed by an expert and professional medical personnel to ensure the accuracy of examination results. Fetal abdominal subcutaneous thickness and fetal thigh circumference were measured for assessment of gestational age and correlated with actual fetal body weight. In the current study, three formulas;Hadlock, Vintzileos’ and SCT formula were correlated with actual fetal body weight after birth. Results: The present study revealed that TC formula is closer to the actual birth weight, followed by Hadlock formula, while the SCT formula is the furthest from it. Conclusion: To increase the accuracy of birth estimations, regular ultrasound examinations should include fetal thigh circumference measurement.展开更多
This study was undertaken to determine the accuracy of using Ultrasound (US) estimation of twin fetuses by use of Artificial Neural Network. At First, as the training group, we performed US examinations on 186 healthy...This study was undertaken to determine the accuracy of using Ultrasound (US) estimation of twin fetuses by use of Artificial Neural Network. At First, as the training group, we performed US examinations on 186 healthy singleton fetuses within 3 days of delivery. Three input variables were used to construct the ANN model: abdominal circumference (AC), ab-dominal diameter (AD), biparietal diameter (BPD). Then, a total of 121 twin fetuses were assessed sub-sequently as the validation group. In validation group, the mean absolute error and the mean absolute per-cent error between estimated fetal weight and actual fetal weight was 261.77 g and 7.81%, respectively. Results show that, twin estimation of birth weight by ultrasound correlates fairly well with the actual weights of twin fetuses.展开更多
Background:Fetal weight is an important parameter to ensure maternal and child safety.The purpose of this study was to use three-dimensional(3D)limb volume ultrasound combined with fetal abdominal circumference(AC)mea...Background:Fetal weight is an important parameter to ensure maternal and child safety.The purpose of this study was to use three-dimensional(3D)limb volume ultrasound combined with fetal abdominal circumference(AC)measurement to establish a model to predict fetal weight and evaluate its efficiency.Methods:A total of 211 participants with single pregnancy(28-42 weeks)were selected between September 2017 and December 2018 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University.The upper arm(AVol)/thigh volume(TVol)of fetuses was measured by the 3D limb volume technique.Fetal AC was measured by two-dimensional ultrasound.Nine cases were excluded due to incomplete information or the interval between examination and delivery>7 days.The enrolled 202 participants were divided into a model group(134 cases,70%)and a verification group(68 cases,30%)by mechanical sampling method.The linear relationship between limb volume and fetal weight was evaluated using Pearson Chi-squared test.The prediction model formula was established by multivariate regression with data from the model group.Accuracy of the model formula was evaluated with verification group data and compared with traditional formulas(Hadlock,Lee2009,and INTERGROWTH-21st)by paired t-test and residual analysis.Receiver operating characteristic curves were generated to predict macrosomia.Results:AC,AVol,and TVol were linearly related to fetal weight.Pearson correlation coefficient was 0.866,0.862,and 0.910,respectively.The prediction model based on AVol/TVol and AC was established as follows:Y=-481.965+12.194TVol+15.358AVol+67.998AC,R2adj=0.868.The scatter plot showed that when birth weight fluctuated by 5%(i.e.,95%to 105%),the difference between the predicted fetal weight by the model and the actual weight was small.A paired t-test showed that there was no significant difference between the predicted fetal weight and the actual birth weight(t=-1.015,P=0.314).Moreover,the residual analysis showed that the model formula’s prediction efficiency was better than the traditional formulas with a mean residual of 35,360.170.The combined model of AVol/TVol and AC was superior to the Lee2009 and INTERGROWTH-21st formulas in the diagnosis of macrosomia.Its predictive sensitivity and specificity were 87.5%and 91.7%,respectively.Conclusion:Fetal weight prediction model established by semi-automatic 3D limb volume combined with AC is of high accuracy,sensitivity,and specificity.The prediction model formula shows higher predictive efficiency,especially for the diagnosis of macrosomia.展开更多
Objective:To evaluate the accuracy of sonography-estimated fetal weight(EFW)and to determine the potential factors influencing EFW accuracy in the Chinese population.Methods:Eleven widely used formulae were chosen to ...Objective:To evaluate the accuracy of sonography-estimated fetal weight(EFW)and to determine the potential factors influencing EFW accuracy in the Chinese population.Methods:Eleven widely used formulae were chosen to evaluate the accuracy of EFW in 7016 cases in a retrospective cohort study.Nine potential factors(prenatal body mass index[BMI],gestational age[GA],birth weight[BW],fetal sex,fetal presentation,amniotic fluid volume[AFV],seniority of sonographers,the time interval between ultrasonic measurement and delivery,and diabetes mellitus)were analyzed by binary logistic regression to determine whether they influenced sonography-EFW.Results:All 11 models had high correlation coefficients between EFW and BW(r=0.819–0.843).Model 3 was the most accurate formula for the Chinese population.Compared to fetuses with EFW of 2500–3999g,the accuracy of EFW decreased by 69.10%(P<0.001)for fetuses less than 2500g,and decreased by 54.10%(P<0.001)for fetuses larger than 4000g.The accuracy of EFW in female fetuses decreased by 12.70%compared with male fetuses(P=0.021).Compared to the EFW calculated 1-3 days before delivery,the accuracy of the EFW performed 4–7 days before delivery showed a significant decrease(P=0.014).The accuracy of EFW was influenced by the individual measurement accuracy of the sonographers.Maternal BMI,DM,GA,fetal presentation,and AFV did not influence the accuracy of EFW after adjustment.Conclusion:Model 3 was the most accurate model for the Chinese population.The BW,fetal sex,time interval,and technique of the sonographers had different influences on the accuracy of EFW.展开更多
Background: Many centers in Sudan use the reference data for fetal biometry. The recently published population-based reference either overestimated or underestimated the weight of the fetuses. Objective: To establish ...Background: Many centers in Sudan use the reference data for fetal biometry. The recently published population-based reference either overestimated or underestimated the weight of the fetuses. Objective: To establish a national reference for fetal biometry, and weight by gestational age for singleton fetuses in Sudan. Methods: Data were collected on all singleton live births documented in the data collection sheet done at Saudi Hospital from 2015 to 2016 (n = 225). Gestational age estimation was based on the last menstrual period and fetal ultrasound thereafter. Fetal biometry and weight and other 6 fetal weight formulae were assessed. Reference data for fetal growth by gestational age were created. Results: New charts and reference equations are reported in Sudanese population for fetal biparietal diameter, head circumference, abdominal circumference and femur length and fetal weight. Conclusion: We advocate that these reference charts and equations for fetal biometry and weight might be valuable in the clinical use for appropriate ethnic Sudanese.展开更多
Background: Depression is the most prevalent psychiatric disorder in pregnancy and it is associated with psychosocial and obstetric factors. Studies have shown that pregnancy does not prevent women from becoming depre...Background: Depression is the most prevalent psychiatric disorder in pregnancy and it is associated with psychosocial and obstetric factors. Studies have shown that pregnancy does not prevent women from becoming depressed;rather, it may be a time when depression occurs for the first time in some women. Antenatal depression has been identified as a risk factor for post natal depression, adverse obstetric outcomes, poorer neonatal outcomes and higher growth retardation in infants. Purpose: This study aimed to determine the fetal growth outcomes among depressed pregnant women in their third trimester attending antenatal clinic at the Jos University Teaching Hospital (JUTH), Jos, Plateau State, Nigeria. Method: A prospective cohort study design was used to assess 514 women who consented to the study (256 cases and 258 controls). A socio-demographic questionnaire was given to the women to fill out the study entry. Edinburgh Post Natal Depression Scale (EPDS) was used to screen for depression and MINI neuropsychiatric interviews were used to diagnose depression in those women found to be at risk of depression using the EPDS. Ultrasonography was used to determine the fetal weight in the third trimester of pregnancy. The birth weight of the babies born to the women was obtained from the birth register in the labor ward and the fetal growth rate was calculated from the estimated fetal weight on ultrasound scan in late pregnancy and the birth weight of babies. Result: The mean fetal weight in the third trimester for non-depressed women was slightly higher than in depressed women though the difference was not statistically significant (P = 0.431). The difference in the mean calculated fetal growth rate for fetuses of non-depressed women in the third trimester was statistically significantly higher than in depressed women (p = 0.000). Depressed women also had babies with lower birth weight than non-depressed women and the difference was statistically significant (p = 0.00).展开更多
Adverse birth outcomes are a leading cause of mortality in children in China, but the environmental influences of these conditions remain largely unexplained in this population. We aimed to evaluate the levels of poly...Adverse birth outcomes are a leading cause of mortality in children in China, but the environmental influences of these conditions remain largely unexplained in this population. We aimed to evaluate the levels of polycyclic aromatic hydrocarbons (PAHs) in Chinese pregnant women and their newborns, and to examine the association between levels of PAHs and infant birth weight. We conducted a cross-sectional study including 81 pairs of mothers and newborns from four hospitals in four different cities in China. High Performance Liquid Chromatography was used to measure the concentration of nine PAHs in maternal and cord blood and multiple linear regression analyses were used to evaluate the associations of these PAHs with infant birth weight. Anthracene (ANT) had the highest average concentration and detection rate (geometric mean = 69.54 ng/g and 76.5%, respectively) in maternal serum samples, while fluoranthene (FLT) had the highest concentration and detection rate (geometric mean = 68.4 ng/g and 50.6%, respectively) in the cord blood. Most of the measured PAHs in maternal serum and three PAHs in cord blood were inversely but non-significantly associated with birth weight. The strongest associations were observed for higher concentrations of benzo (a) pyrene (BaP) in maternal serum (230.7 g decrease for levels > median vs. < LOD;p = 0.151) and for ANT in cord blood (153.1 g decrease for levels < median vs. < LOD;p = 0.208). Ant and FLT were the predominant PAHs in the maternal and cord blood serum. Serum concentrations of several measured PAHs were associated with a decreased birth weight, although not significantly, suggesting that further studies with larger sample sizes are needed to validate our findings.展开更多
Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and...Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and mothers with perinatal complications) and controls (pairs free of perinatal complication) of singleton live births were extracted from the maternity registry from January 2017 to December 2019. Matching was done for sex and gestational age after exclusion of genetic cause of macrosomia. The main primary outcome was the risk factors for complications. Logistic regression was used to estimate the odds ratio and the magnitude of association between the primary endpoint and the different covariates of the study. Results: Out of 362 couples included, we had 186 cases and 176 controls. The main perinatal complications were the delivery by caesarean section (26.5%) and lesions of the genital canal, 20.2%. There were no maternal deaths. Among newborns, metabolic complications (19.6%) were a leading cause of harmful outcomes before respiratory complications (12.4%), dystocic presentations (6.3%) or traumatic injuries (1.7%). The neonatal case fatality rate was 2.8%. Maternal age ≥30 years (p = 0.024);non-screening for gestational diabetes (p = 0.027);history of caesarean section (p = 0.041);weight gain ≥16 kg (p 0.001);maternal HIV (p = 0.047);birth weight ≥4500 g (p = 0.015) and birth height ≥52.7 ± 1.7 cm (p = 0.026) were risk factors for perinatal adverse outcomes. Conclusion: The delivery of a macrosomic baby remains problematic in this setting, and emphasizes the need to improve routine screening of gestational diabetes within a quality of prenatal follow-up through a multidisciplinary perinatal team involving obstetricians, endocrinologists and neonatal pediatricians.展开更多
文摘The objective of this study is to assess commonly used formulae (Sheppard, Campbell, Hadlock I, II, III, and IV) for estimation of fetal weight in Sudanese population. A descriptive cross-sectional study was conducted at Saudi Hospital-Khartoum-Sudan;from December 2015 to April 2016. The study included 225 singleton pregnancies. The fetal biometry—Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) and actual birth weights (ABW) were taken. Statistical analysis showed significant results at p ≤ 0.005. Results showed that the significant highest positive correlation between the ABW and the EFW/Kg was seen in the Hadlock I, III and IV equations having an equal values (0.951) followed by Hadlock II (0.946), Sheppard (0.872) and lastly Campbell (-0.925) with significant high degree of negative correlation. The new established equation EFW<sub>FLHCAC</sub> is the best formula identified in our study to predict Sudanese babies weight ranged between 1.86 Kg to 3.987 Kg.
文摘Background: Fetal weight estimation by ultrasound is an important factor in obstetrics;it is directly related to the gestational age which helps to plan the mode of delivery and labor management. Objective: to compare between fetal thigh circumference (TC) and abdominal subcutaneous tissue thickness (SCT) in estimating birthweight in term pregnant women. Patients and Methods: This prospective cohort study was conducted at outpatient clinic or emergency room, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University Maternity Hospitals from March 2022 until May 2023. During this study, 100 term pregnant females with gestational age 37 - 40 weeks attended El Demerdash Maternity Hospital and scheduled for delivery either at outpatient clinic or emergency room were enrolled, after consenting each of them. Basic fetal biometry was performed by an expert and professional medical personnel to ensure the accuracy of examination results. Fetal abdominal subcutaneous thickness and fetal thigh circumference were measured for assessment of gestational age and correlated with actual fetal body weight. In the current study, three formulas;Hadlock, Vintzileos’ and SCT formula were correlated with actual fetal body weight after birth. Results: The present study revealed that TC formula is closer to the actual birth weight, followed by Hadlock formula, while the SCT formula is the furthest from it. Conclusion: To increase the accuracy of birth estimations, regular ultrasound examinations should include fetal thigh circumference measurement.
文摘This study was undertaken to determine the accuracy of using Ultrasound (US) estimation of twin fetuses by use of Artificial Neural Network. At First, as the training group, we performed US examinations on 186 healthy singleton fetuses within 3 days of delivery. Three input variables were used to construct the ANN model: abdominal circumference (AC), ab-dominal diameter (AD), biparietal diameter (BPD). Then, a total of 121 twin fetuses were assessed sub-sequently as the validation group. In validation group, the mean absolute error and the mean absolute per-cent error between estimated fetal weight and actual fetal weight was 261.77 g and 7.81%, respectively. Results show that, twin estimation of birth weight by ultrasound correlates fairly well with the actual weights of twin fetuses.
文摘Background:Fetal weight is an important parameter to ensure maternal and child safety.The purpose of this study was to use three-dimensional(3D)limb volume ultrasound combined with fetal abdominal circumference(AC)measurement to establish a model to predict fetal weight and evaluate its efficiency.Methods:A total of 211 participants with single pregnancy(28-42 weeks)were selected between September 2017 and December 2018 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University.The upper arm(AVol)/thigh volume(TVol)of fetuses was measured by the 3D limb volume technique.Fetal AC was measured by two-dimensional ultrasound.Nine cases were excluded due to incomplete information or the interval between examination and delivery>7 days.The enrolled 202 participants were divided into a model group(134 cases,70%)and a verification group(68 cases,30%)by mechanical sampling method.The linear relationship between limb volume and fetal weight was evaluated using Pearson Chi-squared test.The prediction model formula was established by multivariate regression with data from the model group.Accuracy of the model formula was evaluated with verification group data and compared with traditional formulas(Hadlock,Lee2009,and INTERGROWTH-21st)by paired t-test and residual analysis.Receiver operating characteristic curves were generated to predict macrosomia.Results:AC,AVol,and TVol were linearly related to fetal weight.Pearson correlation coefficient was 0.866,0.862,and 0.910,respectively.The prediction model based on AVol/TVol and AC was established as follows:Y=-481.965+12.194TVol+15.358AVol+67.998AC,R2adj=0.868.The scatter plot showed that when birth weight fluctuated by 5%(i.e.,95%to 105%),the difference between the predicted fetal weight by the model and the actual weight was small.A paired t-test showed that there was no significant difference between the predicted fetal weight and the actual birth weight(t=-1.015,P=0.314).Moreover,the residual analysis showed that the model formula’s prediction efficiency was better than the traditional formulas with a mean residual of 35,360.170.The combined model of AVol/TVol and AC was superior to the Lee2009 and INTERGROWTH-21st formulas in the diagnosis of macrosomia.Its predictive sensitivity and specificity were 87.5%and 91.7%,respectively.Conclusion:Fetal weight prediction model established by semi-automatic 3D limb volume combined with AC is of high accuracy,sensitivity,and specificity.The prediction model formula shows higher predictive efficiency,especially for the diagnosis of macrosomia.
基金the Natural Science Foundation of the First Affiliated Hospital of Soochow University(BXQN202222)。
文摘Objective:To evaluate the accuracy of sonography-estimated fetal weight(EFW)and to determine the potential factors influencing EFW accuracy in the Chinese population.Methods:Eleven widely used formulae were chosen to evaluate the accuracy of EFW in 7016 cases in a retrospective cohort study.Nine potential factors(prenatal body mass index[BMI],gestational age[GA],birth weight[BW],fetal sex,fetal presentation,amniotic fluid volume[AFV],seniority of sonographers,the time interval between ultrasonic measurement and delivery,and diabetes mellitus)were analyzed by binary logistic regression to determine whether they influenced sonography-EFW.Results:All 11 models had high correlation coefficients between EFW and BW(r=0.819–0.843).Model 3 was the most accurate formula for the Chinese population.Compared to fetuses with EFW of 2500–3999g,the accuracy of EFW decreased by 69.10%(P<0.001)for fetuses less than 2500g,and decreased by 54.10%(P<0.001)for fetuses larger than 4000g.The accuracy of EFW in female fetuses decreased by 12.70%compared with male fetuses(P=0.021).Compared to the EFW calculated 1-3 days before delivery,the accuracy of the EFW performed 4–7 days before delivery showed a significant decrease(P=0.014).The accuracy of EFW was influenced by the individual measurement accuracy of the sonographers.Maternal BMI,DM,GA,fetal presentation,and AFV did not influence the accuracy of EFW after adjustment.Conclusion:Model 3 was the most accurate model for the Chinese population.The BW,fetal sex,time interval,and technique of the sonographers had different influences on the accuracy of EFW.
文摘Background: Many centers in Sudan use the reference data for fetal biometry. The recently published population-based reference either overestimated or underestimated the weight of the fetuses. Objective: To establish a national reference for fetal biometry, and weight by gestational age for singleton fetuses in Sudan. Methods: Data were collected on all singleton live births documented in the data collection sheet done at Saudi Hospital from 2015 to 2016 (n = 225). Gestational age estimation was based on the last menstrual period and fetal ultrasound thereafter. Fetal biometry and weight and other 6 fetal weight formulae were assessed. Reference data for fetal growth by gestational age were created. Results: New charts and reference equations are reported in Sudanese population for fetal biparietal diameter, head circumference, abdominal circumference and femur length and fetal weight. Conclusion: We advocate that these reference charts and equations for fetal biometry and weight might be valuable in the clinical use for appropriate ethnic Sudanese.
文摘Background: Depression is the most prevalent psychiatric disorder in pregnancy and it is associated with psychosocial and obstetric factors. Studies have shown that pregnancy does not prevent women from becoming depressed;rather, it may be a time when depression occurs for the first time in some women. Antenatal depression has been identified as a risk factor for post natal depression, adverse obstetric outcomes, poorer neonatal outcomes and higher growth retardation in infants. Purpose: This study aimed to determine the fetal growth outcomes among depressed pregnant women in their third trimester attending antenatal clinic at the Jos University Teaching Hospital (JUTH), Jos, Plateau State, Nigeria. Method: A prospective cohort study design was used to assess 514 women who consented to the study (256 cases and 258 controls). A socio-demographic questionnaire was given to the women to fill out the study entry. Edinburgh Post Natal Depression Scale (EPDS) was used to screen for depression and MINI neuropsychiatric interviews were used to diagnose depression in those women found to be at risk of depression using the EPDS. Ultrasonography was used to determine the fetal weight in the third trimester of pregnancy. The birth weight of the babies born to the women was obtained from the birth register in the labor ward and the fetal growth rate was calculated from the estimated fetal weight on ultrasound scan in late pregnancy and the birth weight of babies. Result: The mean fetal weight in the third trimester for non-depressed women was slightly higher than in depressed women though the difference was not statistically significant (P = 0.431). The difference in the mean calculated fetal growth rate for fetuses of non-depressed women in the third trimester was statistically significantly higher than in depressed women (p = 0.000). Depressed women also had babies with lower birth weight than non-depressed women and the difference was statistically significant (p = 0.00).
文摘Adverse birth outcomes are a leading cause of mortality in children in China, but the environmental influences of these conditions remain largely unexplained in this population. We aimed to evaluate the levels of polycyclic aromatic hydrocarbons (PAHs) in Chinese pregnant women and their newborns, and to examine the association between levels of PAHs and infant birth weight. We conducted a cross-sectional study including 81 pairs of mothers and newborns from four hospitals in four different cities in China. High Performance Liquid Chromatography was used to measure the concentration of nine PAHs in maternal and cord blood and multiple linear regression analyses were used to evaluate the associations of these PAHs with infant birth weight. Anthracene (ANT) had the highest average concentration and detection rate (geometric mean = 69.54 ng/g and 76.5%, respectively) in maternal serum samples, while fluoranthene (FLT) had the highest concentration and detection rate (geometric mean = 68.4 ng/g and 50.6%, respectively) in the cord blood. Most of the measured PAHs in maternal serum and three PAHs in cord blood were inversely but non-significantly associated with birth weight. The strongest associations were observed for higher concentrations of benzo (a) pyrene (BaP) in maternal serum (230.7 g decrease for levels > median vs. < LOD;p = 0.151) and for ANT in cord blood (153.1 g decrease for levels < median vs. < LOD;p = 0.208). Ant and FLT were the predominant PAHs in the maternal and cord blood serum. Serum concentrations of several measured PAHs were associated with a decreased birth weight, although not significantly, suggesting that further studies with larger sample sizes are needed to validate our findings.
文摘Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and mothers with perinatal complications) and controls (pairs free of perinatal complication) of singleton live births were extracted from the maternity registry from January 2017 to December 2019. Matching was done for sex and gestational age after exclusion of genetic cause of macrosomia. The main primary outcome was the risk factors for complications. Logistic regression was used to estimate the odds ratio and the magnitude of association between the primary endpoint and the different covariates of the study. Results: Out of 362 couples included, we had 186 cases and 176 controls. The main perinatal complications were the delivery by caesarean section (26.5%) and lesions of the genital canal, 20.2%. There were no maternal deaths. Among newborns, metabolic complications (19.6%) were a leading cause of harmful outcomes before respiratory complications (12.4%), dystocic presentations (6.3%) or traumatic injuries (1.7%). The neonatal case fatality rate was 2.8%. Maternal age ≥30 years (p = 0.024);non-screening for gestational diabetes (p = 0.027);history of caesarean section (p = 0.041);weight gain ≥16 kg (p 0.001);maternal HIV (p = 0.047);birth weight ≥4500 g (p = 0.015) and birth height ≥52.7 ± 1.7 cm (p = 0.026) were risk factors for perinatal adverse outcomes. Conclusion: The delivery of a macrosomic baby remains problematic in this setting, and emphasizes the need to improve routine screening of gestational diabetes within a quality of prenatal follow-up through a multidisciplinary perinatal team involving obstetricians, endocrinologists and neonatal pediatricians.
