Regional Variation and Factors Associated With Fetal Macrosomia in Ethiopia

Abstract Background: Globally, there is an increase in the prevalence and incidence of fetal macrosomia. In Sub-Sahara African countries including Ethiopia, all infants were not weighed at birth, and there is a limit to knowledge regarding fetal macrosomia in Ethiopia. The main objective of this study is to assess the regional variation and determinants of fetal macrosomia using the multilevel logistic regression model.Methods: The study was based on the recent Ethiopian Demographic and Health Survey of 2016. A total of 2110 weighted infants at birth were extracted. Multilevel logistic regression analysis is performed to identify the factors associated with fetal macrosomia after various candidate models for their efficiency have been compared based on Akaike’s Information Criteria. Chi-square test of association and the inter-class correlation (ICC) are used to test and compute the variation of fetal macrosomia among the regions, respectively.Results: The overall prevalence of fetal macrosomia among the weighted infants at birth is 219 (10.4%). Based on the estimated chi-square test, there is a significant difference in fetal macrosomia across the regions of Ethiopia. The ICC reveals that 14% of the variation in fetal macrosomia can be explained by grouping the infants into the regions. Random intercept with fixed slope model fits the study data well as compared to the other competitors. Based on this model, the age of the mother, residence, educational level of mother, body mass index of mother, gestational age, wealth index, multiple pregnancies, and the infant sex are the significant factors associated with fetal macrosomia in all regions of Ethiopia.Conclusion: Concerned bodies, including the ministry of health and its hierarchical body, need to give special support and attention to women aged between 35 and 49, post-term pregnant women, and overweight or obese women to minimize the prevalence of fetal macrosomia.