Birth of macrosomia. These include high pre-pregnancy Body Mass

Birth weight is an
essential indicator for assessing child health in terms of early exposure to childhood
morbidity and mortality. 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 12.The neonate is considered to be
macrosomic when its birth weight is greater than 4000-4500 g or greater than
90% for gestational age 34. Thus, measuring the birth weight soon
after delivery can
be a fundamental tool for the diagnosis of the fetal macrosomia 5.

On one hand, cesarean
delivery, labor augmentation with oxytocin, protracted labor, postpartum
hemorrhage, infection, 3rd- and 4th-degree perineal tears, and thromboembolic
events are well-known risks that macrosomic newborn poses to the mother 678. 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 3910. High birth weight has also been associated
with subsequent childhood and adult overweight or obesity 11. On the other hand, 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 1213. Prior literature has identified potential risk factors related to
the causation of macrosomia. These include high pre-pregnancy Body Mass Index
(BMI) 14, excessive weight gain during
pregnancy 15, gestational diabetes and fasting
blood glucose 16, multiparty, male sex, and
parental height 31718.

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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 19. Thus, we aimed to explore the risk
factors associated with fetal macrosomia.