Birth 4000-4500 g or greater than 90%

Birth weight is an
essential indicator for assessing child health in terms of early exposure to morbidity
and mortality in young children. Described as a newborn with an excessive birth
weight, fetal macrosomia has become one of the major public health concern because
of its increased risks for both mothers and infants 12.The neonate is considered to be
macrosomic when its birth weight is greater than 4000-4500 g or greater than
90% for gestational age 34. Thus, measuring the birth weight soon
after delivery can
be a fundamental tool for the diagnosis of the fetal macrosomia 5.

Caesarean
delivery, protracted labor, labor augmentation with oxytocin, and postpartum
hemorrhage, infection, 3rd- and 4th-degree perineal tears, thromboembolic
events are well-known risks that macrosomic newborn poses to the mother 67. Whilst birth trauma (shoulder
dystocia, brachial plexus injury, skeletal injuries), prenatal asphyxia,
hypoglycemia, fetal death as well as increased risks of developing hypertension,
obesity, and type 2 diabetes later in life, are the risks of macrosomia in
infants 3. Several studies have identified potential
risk factors related to the causation of macrosomia. The risk factors
include high pre-pregnancy Body Mass Index (BMI), excessive weight gain during
pregnancy, gestational diabetes and fasting blood glucose, multiparty, male
sex, parental height, and prolonged gestation 38.

A broad understanding of the underlying risk
factors is essential to inform well-designed preventive and management efforts.
In Malawi, most efforts have been concentrated on under-nutrition as well as
low birthweight in children under the age five. However, fetal macrosomia has
received no attention despite its detrimental effects on childhood health
outcomes. According to the Malawi Demographic and Health Survey (MDHS), Four
percent of births are reported as very small, 12% as smaller than average, and
83% as average as or larger than average 9. Thus, we aimed to investigate the factors
associated with fetal macrosomia