The aim of this research was to determine the incidence, risk factors and perinatal outcome of the macrosomic infants (birth weight > or = 4000 g). The retrospective research was performed using a case-control study conducted at Mostar Clinical Hospital. Total of 379 women gave singleton term births to macrosomic newborn in the period from January 1st, 2004 to December 31st, 2005 (observed group). Another 379 singleton normal birthweight term newborns (birth weight < 4000 g, but not small for gestational age), of the same maternal parity and age, who were delivered in the same period, formed the control group. The incidence of macrosomic births was 13, 1%. In the study group, significantly higher number of cases of postdatism (> 42 weeks of gestation) (P<0,001), maternal obesity (prepregnancy BMI> 26 kg/m2) (P<0,001), gestational diabetes mellitus (P=0,033), hypertension (P=0,025) and male infant (P<0,001) were observed. Cesarean delivery (P<0,001), intrapartal complications (cephalopelvic disproportion P<0.001, perineal trauma P=0,042) and newborn birth trauma (clavicular fracture P=0,038, brachial palsy P=0,021) occurred significantly more often in the macrosomic group. There was only one fetal death in the macrosomic group. In the control group there were no cases of perinatal deaths. To conclude, it is important to emphasize the significance of proper diagnosis of fetal macrosomia and management of macrosomic birth, since we have seen a growing number of macrosomic births during the last decades, and have faced a problem of increased risks of adverse perinatal outcome.
Background:The prevalence of gestational diabetes mellitus (GDM), as a complex problem in pregnancy, is increasing all over the world, but most noticeable in developing countries.Aims:To estimate GDM prevalence and associated pregnancy features in the southern part of Bosnia and Herzegovina.Methods:A cross-sectional observational study was conducted from October 2010 through March 2011. A total of 285 pregnant women with singleton pregnancies participated and were asigned to the study in the order they came for their usual ante-natal clinic examination. They underwent an oral glucose tolerance test (OGTT) with 75 g of glucose. Information on OGTT results, maternal characteristics and pregnancy outcomes were collected from database and medical records.Results:Prevalence of GDM was 10.9% according to 1999 World Health Organisation (WHO) diagnostic criteria. Prenatal cigarette smoking, previous GDM, cesarean delivery rate and neonatal hypoglycemia were significantly more frequent in the GDM group compared to the group of pregnancies with normal glucose tolerance (p = 0.015, p < 0.001, p = 0.015, p = 0.002).Conclusion:This study presents a relatively high prevalence of GDM in Bosnia and Herzegovina. There is a need for large well-designed study on GDM prevalence and its other features.
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