Birth become one of the major public health concern

Birth weight is an
essential indicator for assessing child health in terms of early exposure to childhood
morbidity and mortality 12. Described as a newborn with an
excessive birth weight, fetal macrosomia has become one of the major public
health concern because of its increased risks for both mothers and infants 34.The neonate is considered to be
macrosomic when its birth weight is greater than 4000-4500 g or greater than
90% for gestational age 56. Thus, measuring the birth weight soon
after delivery can
be a fundamental tool for the diagnosis of the fetal macrosomia 7.

On one hand, protracted
labor, cesarean delivery, labor augmentation with oxytocin, postpartum
hemorrhage, infection, 3rd- and 4th-degree perineal tears, and thromboembolic
events are well-known risks that macrosomic newborn poses to the mother 8910. On the other hand, birth trauma (shoulder
dystocia, brachial plexus injury, skeletal injuries), prenatal asphyxia,
hypoglycemia, fetal death are the risks of macrosomia in infants 5101112. Furthermore, high birth weight
has also been associated with subsequent childhood and adult overweight or obesity
13. Consequently, overweight/obese
children are more likely to develop non-communicable diseases such as type II
diabetes and cardiovascular diseases at both younger and older ages 1415. Prior literature has identified potential risk factors related to
the causation of macrosomia. These include high pre-pregnancy Body Mass Index
(BMI) 16, excessive weight gain during
pregnancy 17, gestational diabetes and fasting
blood glucose 18, multiparty, male sex, and
parental height 51920.

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A broad
understanding of the underlying risk factors is essential to inform
well-designed preventive and management efforts. In Malawi, most efforts have
been concentrated on under-nutrition as well as low birthweight in children
under the age five. However, fetal macrosomia has received no attention despite
its detrimental effects on childhood health outcomes. According to the 2015-16 Malawi
Demographic and Health Survey (MDHS), Four percent of births are reported as
very small, 12% as smaller than average, and 83% as average or larger than
average 21. Thus, we aimed to explore the risk
factors associated with fetal macrosomia.

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