Risk Factors for Fetal Macrosomia: Maternal determinantsand neonatal impacts – literature review
DOI:
https://doi.org/10.33448/rsd-v14i6.48891Keywords:
Fetal macrosomia, Risk factors, Nursing, High-risk pregnancy, Newborn.Abstract
Fetal macrosomia, defined as the birth of a newborn weighing 4,000 g or more or above the 90th percentile for gestational age, represents a significant obstetric challenge due to its impact on maternal and neonatal morbidity and mortality. This study aimed to identify the main maternal determinants of fetal macrosomia, analyze possible interactions between risk factors, and discuss neonatal outcomes and preventive strategies. An integrative literature review was conducted using national databases. The findings indicate that gestational diabetes, maternal obesity, excessive gestational weight gain, advanced maternal age, multiparity, tall maternal stature, post-term pregnancy, and male fetal sex are the primary associated factors. Furthermore, the coexistence of these factors exerts a synergistic effect, substantially increasing the risk of macrosomia. The most common neonatal complications include shoulder dystocia, hypoglycemia, birth trauma, polycythemia, and a higher incidence of cesarean delivery, in addition to an increased predisposition to metabolic disorders during childhood and adulthood. Preventive strategies involve strict glycemic control, appropriate monitoring of maternal weight gain, ultrasonographic surveillance of fetal growth, and individualized obstetric management. It is concluded that reducing the incidence and complications of fetal macrosomia requires integrated actions involving high-quality prenatal care, health education, and evidence-based interventions.
References
Andrade, N. G. A. et al. (2024). A relação entre diabetes gestacional e macrossomia fetal: consequências obstétricas e pediátricas. Brazilian Journal of Implantology and Health Sciences, 6(11), 2862-2879, 2024.
Arias, F. (2018). Obstetrics and gynecology: a competency-based companion. New York: McGraw-Hill Education, 2018.
Bandarra, A. R. C. (2014). Macrossomia na diabetes gestacional. 2014. Dissertação (Mestrado) – Universidade de Coimbra, Coimbra, Portugal, 2014.
Bispo, J. F. et al. (2019). Fatores de risco da macrossomia fetal em mães com diabetes gestacional e seus respectivos recém-nascidos. Gep News, 3(3), 65-67, 2019.
Bo, P.; & Rizzo, N. (2014). Maternal obesity and fetal growth: long-term consequences for offspring. Obstetrics and Gynecology Clinics of North America, 41(4), 569-578, 2014.
Buitendijk, S. E. et al. (2019). Pregnancy outcomes and maternal risk factors for large for gestational age infants. The European Journal of Obstetrics & Gynecology and Reproductive Biology, 235, 9-14, 2019.
Calderon, I. D. M. P.; & Rudge, M. V. C. (2006). Macrossomia fetal: um desafio obstétrico. Revista Brasileira de Ginecologia e Obstetrícia, 28, 211-213, 2006.
Fiorelli, L. R.; & Zugaib, M. (2007). Resultado perinatal na macrossomia fetal. Revista de Medicina, 86(3), 144-147, 2007.
Gonzaga, G. C. S. (2018). Macrossomia fetal como consequência da diabetes mellitus gestacional. [S. l.], 2015.
Júnior, R. N. C. C. et al. (2023). Revisão integrativa, sistemática e narrativa: aspectos importantes na elaboração de uma revisão de literatura. Revista ACB: Biblioteconomia em Santa Catarina, 28(1), 11, 2023.
Kerche, L. T. R. L. et al. (2005). Fatores de risco para macrossomia fetal em gestações complicadas por diabete ou por hiperglicemia diária. Revista Brasileira de Ginecologia e Obstetrícia, 27, 580-587, 2005.
Landon, M. B.; & Spong, C. Y. (2008). Diabetes and pregnancy: epidemiology and outcomes. Clinical Obstetrics and Gynecology, 51(2), 245-257, 2008.
Madi, J. M. et al. (2006). Fatores maternos e perinatais relacionados à macrossomia fetal. Revista Brasileira de Ginecologia e Obstetrícia, 28, 232-237, 2006.
Oliveira, G. (2023). Agregação de fatores de risco para diabetes mellitus gestacional e a macrossomia fetal em participantes do Projeto Viver. [S. l.], 2023.
Oliveira, G.; Miguez, F. G. G.; & Oliveira, E. R. A. (2024). Agregação de fatores de risco à macrossomia fetal em participantes do Projeto Viver. Revista da Faculdade de Ciências Médicas de Sorocaba, v. 26, fluxo contínuo, e64497, 2024.
Oliveira, R. M. A. et al. (2022). Macrossomia fetal e o risco de obesidade infantil. Research, Society and Development, 11(7), e5211729572, 2022.
Rezende Pivoto, G. P.; Da Silva, L. F. R.; & Oppenheimer, D. (2023). Macrossomia fetal como complicação da diabetes gestacional e a eficácia da dieta e exercícios físicos como tratamento primário: revisão de literatura. Research, Society and Development, 12(10), e23121043354, 2023.
Ribeiro, S. P.; Costa, R. B.; & Dias, C. P. (2017). Macrossomia neonatal: fatores de risco e complicações pós-parto. Nascer e Crescer – Birth and Growth Medical Journal, 26(1), 21-30, 2017.
Ritter, J. B. et al. (2025). Relação entre obesidade materna, diabetes gestacional e macrossomia fetal: uma revisão baseada em evidências. Brazilian Journal of Health Review, 8(1), e77888, 2025.
Schroff, K. J. E. (2024). Estudo dos fatores de risco para macrossomia em recém-nascidos de uma maternidade pública do Distrito Federal e desenvolvimento de guia orientador para detecção precoce. [S. l.], 2024.
Silva, A. T. et al. (2007). Macrossomia: consequências e estratégias de prevenção. Femina, p. 317-321, 2007.
Tourinho, A. B.; & Reis, M. L. B. D. S. (2012). Peso ao nascer: uma abordagem nutricional. Comunicações em Ciências da Saúde, p. 19-30, 2012.
Viggiano, M. G. C.; Botelho, N. M.; & Monteiro, A. M. (1987). Macrossomia fetal. Jornal Brasileiro de Ginecologia, p. 423-428, 1987.
World Health Organization (WHO). (2016). Recommendations on antenatal care for a positive pregnancy experience. Geneva: WHO, 2016.
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Copyright (c) 2025 Ezequiel Alves Pereira; Gabrielly Lanna Rodrigues Barbosa; Patrick Mendonça Faustino; Yasmin Emanuelle Rosa Souza; Igor Júnior da Silva; Elciana de Oliveira Emerick Coelho
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