Macrosomia and Associated Factors among Newborns Delivered at Asella Teaching and Referral Hospital, Southeast Ethiopia, 2025

Abstract

Abstract Background: Fetal macrosomia defined as birth weight of 4000 g and above regardless of gestational age. Globally, macrosomia affects 8 to 12% of normal pregnancy. Fetal macrosomia increases maternal risks like postpartum hemorrhage, prolonged labor, perineal tears, and cesarean delivery, while newborns face risks such as perinatal asphyxia, meconium aspiration, and birth injuries like clavicular fractures. In resource-limited settings, these complications are heightened due to limited obstetric and neonatal care, especially in developing countries. Objectives: This study aims to Asses Prevalence and Factors Associated with Macrosomia Among Newborns Delivered in AR at Arsi University Referral and Teaching Hospital in 2025. Methodology: A Facility based Cross-Sectional design was employed from August-October 2025. Data were collected through direct interviews, along with measuring the newborn weight, and supported by a review of medical records. The collected data were exported from Kobo toolbox to SPSS for thorough analysis. Descriptive statistics were used to summarize sociodemographic, obstetric, and clinical characteristics of the study participants. Bivariate analysis was initially conducted and Variables with a p-value <0.25 in the bivariate analysis was included in the multivariable logistic regression model to control for potential confounders. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) was used to measure the strength of association, and statistical significance was declared at p-value <0.05.

Results: The prevalence of macrosomia was 12.9% (95% CI: 10.0%–15.9%).. In multivariable analysis, maternal age ≥35 years (AOR = 2.1; 95% CI: 1.36–7.45), urban residency (AOR = 1.26; 95% CI: 1.07–5.94), college-level or higher education (AOR = 4.4; 95% CI: 1.44–43.38), pre-pregnancy overweight (AOR = 6.2; 95% CI: 1.59–23.71), and obesity (AOR = 13.1; 95% CI: 2.28–74.23) were significant predictors of macrosomia. Conclusion: The study found a relatively high prevalence of macrosomia, with advanced maternal age, urban residence, higher maternal education, and pre-pregnancy overweight and obesity significantly increasing the risk. Interventions focusing on maternal weight management and lifestyle modification, especially among older and urban women, are critical to reduce macrosomia-related complication