Searching for the definition of macrosomia through an outcome-based approach in low- and middle-income countries: a secondary analysis of the WHO Global Survey in Africa, Asia and Latin America
Ye, J.; Torloni, M.Regina.; Ota, E.; Jayaratne, K.; Pileggi-Castro, C.; Ortiz-Panozo, E.; Lumbiganon, P.; Morisaki, N.; Laopaiboon, M.; Mori, R.; Tunçalp, Özge.; Fang, F.; Yu, H.; Souza, Jão.Paulo.; Vogel, J.Peter.; Zhang, J.
Bmc Pregnancy and Childbirth 15: 324
2015
ISSN/ISBN: 1471-2393 PMID: 26634821 DOI: 10.1186/s12884-015-0765-zDocument Number: 641499
No consensus definition of macrosomia currently exists among researchers and obstetricians. We aimed to identify a definition of macrosomia that is more predictive of maternal and perinatal mortality and morbidity in low- and middle-income countries. We conducted a secondary data analysis using WHO Global Survey on Maternal and Perinatal Health data on Africa and Latin America from 2004 to 2005 and Asia from 2007 to 2008. We compared adverse outcomes, which were assessed by the composite maternal mortality and morbidity index (MMMI) and perinatal mortality and morbidity index (PMMI) in subgroups with birthweight (3000-3499 g ) when birthweight was greater than 4500 g in Latin America. When birthweight was at the 90(th) percentile or higher, aORs of MMMI and PMMI increased, but none exceeded 2.0. The population-specific definition of macrosomia using birthweight cut-off points irrespective of gestational age (4500 g in Africa and Latin America, 4000 g in Asia) is more predictive of maternal and perinatal adverse outcomes, and simpler to apply compared to the definition based on birthweight percentile for a given gestational age.