Epidemiological, Diagnostic, Therapeutic and Evolutionary Profile of the Newborn Macrosome at the University Teaching Hospital of Bouake (Cote D'ivoire)

Objective: To describe the main epidemiological, diagnostic, therapeutic and evolutionary aspects of the newborn macrosome in neonatology at Bouaké University teaching Hospital.

Methods: This was a prospective, descriptive and analytical study carried out in the neonatology unit of the Bouaké CHU from January to November 2019. Included were all newborns with a birth weight ≥ 4000g after parental consent. The variables studied were sociodemographic, diagnostic, therapeutic and evolutionary.

Results: A total of 1557 newborns were registered including 130 macrosomes (87 boys and 43 girls) or 8.3%. The age of the mother was ≥30ans in 53.8% of the cases. She had a history of large fetus (46.2%), maternal and/or familial obesity/overweight (71.5%), gestational diabetes (10.4%) and pre-existing diabetes (3.9%). The main physical signs at admission were general (34.2%), respiratory (27.7%) and neurological (22.3%). Hypoglycemia (36.4%), perinatal asphyxia (15.2%) and obstetrical trauma (15.2%) were the main pathologies associated with macrosomia. The evolution was marked by recovery (92.3%), death (6.9%) and discharge against medical advice (0.8%). The significant factors associated with death were resuscitation in the delivery room [P<0.001 - OR 5.55 (1.1-25.62)] and age at admission greater than or equal to 24 hours [p=0.001- OR 9.16 (1.17-418.22)].

Conclusion: Macrosomia is frequent at the Bouaké University teaching Hospital. It often concerns a newborn boy of a diabetic, obese or overweight mother. Lethality is still high. Improvement of the prognosis requires correct follow-up of pregnancies and early management of the newborn. This implies a perfect collaboration between the gynecologist-obstetrician, the midwife and the pediatrician.

Keywords: newborn, macrosome, etiology, prognosis, Côte d’Ivoire.