Determinants of fetal macrosomia among live births in southern Ethiopia: a matched case-control study

Background The magnitude of fetal macrosomia is high and associated with adverse maternal and fetal outcomes, especially among women in developing countries like Ethiopia. Despite the observed burden, there is limited evidence on determinants of fetal macrosomia. This study aimed to identify determinants of fetal macrosomia among live births at Wolaita Sodo town Southern Ethiopia. Methods A facility-based matched case-control study design involved 360 singletons deliveries attended at hospitals in Wolaita Sodo town, southern Ethiopia, with 120 cases and 240 controls included. Cases and control were matched by maternal age. Cases were neonates with a birth weight of ≥4000, while controls were neonates with a birthweight between 2500gm and less than 4000gm. Data were collected by interviews, measuring, and reviewing mothers' medical documents. Conditional logistic regression analysis was carried to identify the independent predictor variables. Statistical significance was set using a p-value<0.05 and 95% CI for AOR. Results Male neonates were four times more likely to be macrosomia than female neonates AOR=4.0 [95%CI; 2.25-7.11, p<0.001]. Neonates born at gestational age ≥40 weeks were 4.33 times more likely to be macrosomia with AOR= 4.33 [95%CI; 2.37-7.91, p<0.001]. Neonates born from physically active mothers were 7.76 times more likely to be macrosomia with AOR= 7.76 [95CI; 3.33-18.08, p<0.001]. Neonates born from mothers who consumed fruits and dairy products in their diet frequently were 2 and 4.9 times more likely to be macrosomia AOR=2.03 [95%CI; 1.11-3.69, p=0.021] and AOR= 4.91[95%CI; 2.36-10.23, p<0.001] respectively. Conclusion Mothers' physical exercise and consumption of fruit and dairy products were significant predictor variables for fetal macrosomia. Hence, health care providers may use these factors as a screening tool for the prediction, early diagnosis, and timely intervention of fetal macrosomia and its complications.