Determination of the Intervention Strategies for the Prevention of Fetal Macrosomia Dependent Cesarean Sections in Nigeria

Abstract

Background: Subsequent to the rising cesarean section rates worldwide over the past three decades, this study was done to determine the risk factors that predispose to fetal macrosomia with the aim of determining the intervention strategies for preventing fetal macrosomia dependent cesarean sections in Nigeria. Subjects and Methods: A record review of the birth weights of 2410 babies delivered in St Philomena's Hospital, a survey of the nutritional habits of 75 mothers of macrosomic babies attending postnatal clinic within the study period, and an assessment of the level of awareness' of the fasting blood glucose status of 75 mothers of macrosomic babies and 330 pregnant women with interviewer administered questionnaire were done. Results: The prevalence rate for fetal macrosomia in St Philomena's Hospital was 8.4% during the study period. Cesarean section rate among women with fetal macrosomia was 39.2% compared to a rate of 18% in women who gave birth to babies with normal birth weight. It was also found that most pregnant women and mothers of macrosomic babies were not aware of their fasting blood glucose status. Majority of mothers of macrosomic babies preferred high glycemic index diets and also consumed sugary beverages on daily basis. Conclusion: Fetal macrosomia is a preventable outcome of pregnancy in the presence of moderate dietary restriction, low glycemic index diets as well as the inclusion of dietary fiber in the diet of pregnant women. Furthermore, a lower incidence of fetal macrosomia is capable of reducing cesarean section rates in Nigeria.