Predictive risk scale for developing a large fetus

BACKGROUND: There is a need to search for early prognostic markers of macrosomia development due to the increase in the incidence of fetal macrosomia, the high risk of maternal and neonatal complications, and the lack of an algorithm for prenatal monitoring. It can improve the accuracy of diagnosis, optimize obstetric management of pregnancy and childbirth, and prevent fetal macrosomia.

AIM: The aim of this study was to develop a scale for predicting macrosomia based on the study of the prognostic value of its risk factors and antifactors.

MATERIALS AND METHODS: The authors conducted a single-center prospective cohort study at the Orenburg Clinical Perinatal Center, Orenburg, Russia, and studied 676 pregnant women with large fetuses (main group) and 600 pregnant women with medium-weight fetuses (control group), as well as their newborns. The observation and study was performed from January 1, 2015 to January 1, 2020.

RESULTS: The large size of the fetus in women without pre-existing and manifest forms of diabetes mellitus is determined to varying degrees by both non-modifiable risk factors and modifiable ones, including obesity, pathological weight gain during pregnancy, especially in the third trimester, excessive consumption of carbohydrates, and low physical activity.

CONCLUSIONS: Calculation of the integrated influence of various factors on the development of a large fetus revealed a number of factors and antifactors in predicting fetal macrosomia. In practical obstetrics, it is advisable to use formalized tables of risk factors for the development of a large fetus, according to the identified prognostic coefficients.