Birth events are well-known risks that a macrosomic

Birth weight is animportant indicator for assessing child health in terms of early exposure tochildhood morbidity and mortality. Described as a newborn with an excessivebirth weight, fetal macrosomia has become one of the major public healthconcern because of its increased risks for both mothers and infants 12.

The neonate is considered to bemacrosomic when its birth weight is greater than 4000-4500 g or greater than90% for gestational age 34. Thus, measuring the birth weight soonafter delivery canbe fundamental tool to the diagnosis of the fetal macrosomia 5.Caesareandelivery, protracted labor, labor augmentation with oxytocin, and postpartumhemorrhage, infection, 3rd and 4th degree perineal tears,thromboembolic events are well-known risks that a macrosomic newborn poses tothe mother 67. Whilst birth trauma (shoulderdystocia, brachial plexus injury, skeletal injuries), prenatal asphyxia,hypoglycemia, fetal death as well as increased risks of developing obesity, hypertension,and type 2 diabetes later in life, are the risks of macrosomia in infants 3. Previous research has identifiedseveral risk factors associated with the causation of macrosomia.

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These includehigh pre-pregnancy Body Mass Index (BMI), excessive weight gain duringpregnancy, gestational diabetes and fasting blood glucose, multiparty, malesex, parental height, and prolonged gestation 38.A comprehensiveunderstanding of the underlying risk factors is essential to informwell-designed preventive and management efforts. In Malawi, most efforts havebeen concentrated on under-nutrition as well as low birthweight in childrenunder the age five.

However, fetal macrosomia has received no attention despiteits detrimental effects on childhood health outcomes. According to the MalawiDemographic and Health Survey (MDHS), Four percent of births are reported asvery small, 12% as smaller than average, and 83% as average as or larger thanaverage 9. Thus, we aimed to investigate thefactors associated with fetal macrosomia.