Prediction of pregnancy complications in pregnancies with big babies

  • Research type

    Research Study

  • Full title

    Prediction of maternal and neonatal complications in pregnancies with large for gestational age neonates

  • IRAS ID

    262820

  • Contact name

    Ranjit Akolekar

  • Contact email

    ranjit.akolekar@nhs.net

  • Sponsor organisation

    Medway NHS Foundation Trust

  • Duration of Study in the UK

    9 years, 11 months, 31 days

  • Research summary

    Macrosomia is commonly defined as a birth weight (BW) of more than 4,000 g. This cut-off corresponds to the 90th percentile at 40 weeks’ gestation and therefore the prevalence of macrosomia in any population is approximately 10%. Macrosomia is associated with maternal complications, such as emergency caesarean section, post-partum haemorrhage (heavy bleeding after delivery) and perineal trauma and neonatal complications, including shoulder dystocia, brachial plexus injury (OBPI), fracture of humerus or clavicle and birth asphyxia.

    There is considerable variation in reported literature with regard to the appropriate management strategy of these big babies. There is evidence that macrosomia can be predicted and diagnosed accurately in the antenatal period using ultrasound. However, there is no national guidance on the identification, diagnosis or management of macrosomia.

    The aim of this study is firstly, to compare the prevalence of pregnancy complications in pregnancies with large for gestational age (LGA) compared to those that are appropriate for gestation. Secondly, to determine whether pregnancy complications in LGA pregnancies can be predicted effectively from maternal and pregnancy characteristics and to establish a prediction model. In those pregnancies that are deemed to be high risk, we aim to assess whether delivery at an earlier gestation is associated with a reduction in the incidence of adverse outcomes.

  • REC name

    London - City & East Research Ethics Committee

  • REC reference

    19/LO/0502

  • Date of REC Opinion

    18 Mar 2019

  • REC opinion

    Favourable Opinion