Abstract
Abstract
Introduction:
Studies on fetal macrosomia remain limited in the Democratic Republic of Congo (DRC). This study aimed to determine the prevalence of fetal macrosomia, identify maternal factors associated with its occurrence, and assess its neonatal outcomes among term newborns in ten health facilities in South Kivu, eastern DRC.
Methods
A cross-sectional study based on retrospective data was conducted between May and September 2023 among 1,247 mother–newborn pairs recruited from ten health facilities across four health zones in South Kivu. Fetal macrosomia was defined as a birth weight ≥ 4,000 g. Logistic regression models were used to identify factors independently associated with fetal macrosomia. Statistical significance was set at p < 0.05.
Results
The prevalence of fetal macrosomia was 6.98%. In univariate analysis, maternal age, gravidity, and parity were significantly associated with macrosomia. However, after adjustment, only maternal obesity remained independently associated with fetal macrosomia (adjusted OR = 2.34; 95% CI: 1.30–4.22; p = 0.004). Fetal macrosomia was also independently associated with an increased risk of neonatal death before discharge (adjusted OR = 9.15; 95% CI: 3.04–27.53; p = 0.001) and the need for intravenous feeding (adjusted OR = 3.22; 95% CI: 1.45–7.15; p = 0.004).
Conclusion
While fetal macrosomia prevalence in South Kivu mirrors sub-Saharan trends, its toll on neonatal mortality remains critical, with maternal obesity identified as the sole independent risk factor. Addressing this challenge requires urgent maternal obesity management and enhanced antenatal surveillance to improve regional maternal and neonatal outcomes.