The prevalence, associated risk factors and pregnancy-related outcomes of large-for-gestational-age newborns delivered at Chris Hani Baragwanath Academic Hospital

Background. Large for gestational age (LGA) refers to a newborn birthweight equal to or greater than the 90th percentile for a given GA. Delivering an LGA newborn poses a high risk of morbidity and mortality for both mother and baby. Objectives. To describe the prevalence of term LGA newborns and identify the factors and pregnancy-related outcomes associated with delivering term LGA newborns at Chris Hani Baragwanath Academic Hospital (CHBAH), a tertiary hospital in Johannesburg, South Africa. Methods. We conducted a retrospective, institution-based cross-sectional study from 1 October 2020 to 31 March 2021, in which 275 LGA singleton term deliveries were reviewed. Patient demographics, medical factors and clinical outcomes were recorded and statistically analysed. Results. The prevalence of LGA newborns in singleton-term deliveries at CHBAH was 3.92%. Associated factors included maternal obesity, multiparity, prolonged pregnancy with a GA >40 weeks, previous LGA delivery and (newborn) male gender. Maternal complications included prolonged labour, increased caesarean delivery, postpartum haemorrhage, obstetric anal sphincter injuries and uterine rupture. Fetal and neonatal complications included shoulder dystocia, neonatal hypoglycaemia, and neonatal respiratory distress syndrome. Conclusions. LGA singleton term deliveries at CHBAH were associated with both maternal and neonatal morbidity. The presence of associated factors should alert maternity caregivers to closely monitor these pregnancies and plan for an appropriate mode of delivery. LGA newborns should be routinely screened and appropriately managed for hypoglycaemia.