Can Macrosomia Be Prevented?

Objective: To determine whether strict glycemic control during diabetic pregnancy combined with elective early induction of labor reduces the rate of macrosomia, birth trauma, and it's influences on the C/S rate. Materials and Methods: Data were collected on the outcome of gestational diabetes (GDM) from 1/1980 to 12/1998. We investigated the relationship between mode of delivery, macrosomia (>4000 g), perinatal morbidity and mortality to maternal glycemic control and departmental delivery protocols. Results: Compared with results before implementation of our management policy there was a statistically significant decline in the incidence of macrosomia (17.9% to 4.5% P<0.05), Induction of labor increased from 15% to 35% of the pregnancies, but the rate of C/S remained unchanged (20.6%, and 17.8%, respectively). Conclusion: Maintaining strict glycemic control and adhering to early elective delivery have a significant effect on reducing tho rate of macrosomia, without affecting the rate of cesarean deliveries.