Risk factors of fetal macrosomia: role of maternal nutrition.

Aim: To assess the effect of maternal diet during pregnancy on the risk of delivering a large for gestational baby (macrosome).

Methods: A food intake survey of 350 healthy pregnant Tunisian women, 52 in group macrosomia and 298 in group control. Only term (> or =37 completed Weeks of gestation) infants were included. All women in the study group completed food frequency questionnaires on their diet in the last 24 hours before delivery.

Results: Frequency of foetal macrosomia was 15.8% (n=52). Pregravid maternal BMI >30 (OR = 3.06 [1.51-6.17]), prolonged term of pregnancy (> 41 weeks of gestation) (OR = 249 [1.04-5.88]) and the antecedent of a macrosomic delivery (OR = 6.53 [2.89-14.74]) were significantly associated with the risk of fetal macrosomia. The mean daily total energetic intakes, protein intakes and carbohydrate intakes were significantly higher in the macrosomia group than in the control group. However, with multivariate analysis after adjustment for term and Pregravid BMI, no significant correlation was found between nutrient intakes and risk of fetal macrosomia.

Conclusion: Maternal food intakes in the end of pregnancy are not a significant determinant of fetal macrosomia compared to maternal BMI, and term of pregnancy.