A COMPARATIVE STUDY OF MACROSOMIA IN INFANTS BORN TO DIABETIC AND NON- DIABETIC MOTHERS

ABSTRACT
Objective: To compare macrosomia in infants of diabetic and non-diabetic mothers, and to study macrosomia associated
shoulder dystocia and mode of delivery.
Material and Methods: This study was carried out on babies born to diabetic as well as non-diabetic healthy mothers
at Gynae unit Hayatabad Medical Complex Peshawar in association with Anatomy department Khyber Girls Medical
College Peshawar. A total number of 100 diabetic and 100 nondiabetic healthy mothers were selected for this study.
After delivery, the weight and sex of the babies born to diabetic as well as nondiabetic mothers along with the mother’s
age, parity and mode of delivery were noted on an observation sheet. The student’s t test was applied for all quantitative
data. A p-value of ≤ 0.05 was taken significant.
Results: Macrosomia was significantly higher in infants of diabetic mothers as compared to those of non-diabetic
mothers (P =0.0001). Compared to infants of non-diabetic mothers, infants of diabetic mothers had a significantly
higher birth weight (P =.0001).Cesarean sections and instrumental deliveries were significantly higher (P = 0.0001) in
diabetic mothers as compared to non-diabetic mothers. No significant difference was found between the mean age (P
=0.655) and parity of the diabetic and non-diabetic mothers. Of the 48 infants of diabetic mothers delivered vaginally,
08 were complicated by shoulder dystocia. Conversely, only 01 of the 79 infants born to non-diabetic mothers delivered
vaginally experienced shoulder dystocia (P value =.022). Of 37 macrosomic infants born to diabetic mothers 26
were male and 11 were females. (P value =.005). Conversely of 6 macrosomic infants born to non-diabetic mothers 4
were males and 2 were females (P value =.679) showing that male infants of diabetic mothers were significantly more
affected by macrosomia.
Conclusion: A significant difference was noted when birth weight of babies born to diabetic mothers was compared
with the babies of nondiabetic mothers. Macrosomia was significantly more common in infants of diabetic women as
compared to those of non -diabetic women. Macrosomia associated shoulder dystocia, instrumental and cesarean
deliveries are also more common in diabetic women than non-diabetic women. This larger weight and macrosomia of
babies may be due to maternal diabetes. This condition affects the normal development of fetus leading to an increased
morbidity and mortality in babies and mothers.
Key Words: Macrosomia, IDMs, Shoulder dystocia, Hyperinsulinemia, Mode of delivery, Cesarean sections, Instrumental
delivery, Parity, Pre-gestational diabetes.