Birth pre-pregnancy Body Mass Index (BMI) 14, excessive

Birth weight is anessential indicator for assessing child health in terms of survival, development,and adult metabolic diseases. Described as a newborn with an excessive birthweight, fetal macrosomia has become one of the major public health concern becauseof its increased risks for both mothers and infants 12.The neonate is considered to bemacrosomic when its birth weight is greater than 4000-4500 g or greater than90% for gestational age 34. Thus, measuring the birth weight soonafter delivery canbe a fundamental tool for the diagnosis of the fetal macrosomia 5.

On one hand, cesareandelivery, labor augmentation with oxytocin, protracted labor, postpartumhemorrhage, infection, 3rd- and 4th-degree perineal tears, and thromboembolicevents are well-known risks that macrosomic newborn poses to the mother 678. On the other hand, birth trauma (shoulderdystocia, brachial plexus injury, skeletal injuries), prenatal asphyxia,hypoglycemia, fetal death are the risks of macrosomia in infants 38910. High birth weight has also been associatedwith subsequent childhood and adult overweight or obesity 11.

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On the other hand, overweight/obesechildren are more likely to develop non-communicable diseases such as type IIdiabetes and cardiovascular diseases at both younger and older ages 1213. Prior literature has identified potential risk factors related tothe causation of macrosomia. These include high pre-pregnancy Body Mass Index(BMI) 14, excessive weight gain duringpregnancy 15, gestational diabetes and fastingblood glucose 16, multiparty, male sex, andparental height 31718.A broadunderstanding of the underlying risk factors is essential to informwell-designed preventive and management efforts. In Malawi, most efforts havebeen concentrated on under-nutrition as well as low birthweight in childrenunder the age five.

However, fetal macrosomia has received no attention despiteits detrimental effects on childhood health outcomes. According to the 2015-16 MalawiDemographic and Health Survey (MDHS), Four percent of births are reported asvery small, 12% as smaller than average, and 83% as average or larger thanaverage 19. Thus, we aimed to explore the riskfactors associated with fetal macrosomia.

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