Étude de l'évolution de la prévalence, des facteurs de risques et des complications materno-fœtales de la macrosomie entre 2006 et 2017 à l'Hôpital de la Conception

Abstract : Introduction: Macrosomia is defined by a birth weight ≥ 4000 g in the long term and is a frequent and feared complication because it is potentially serious for the mother and her child. Risk factors are well known and gestational diabetes (GDM) remains the leading cause. The IADSPG relied on the HAPO study to propose in 2010 new screening criteria for DG in order to reduce the occurrence of maternal-fetal complications and in particular macrosomia. The aim of this study was therefore to compare the evolution of prevalence, risk factors and maternal-fetal complications in non-diabetic and diabetic women treated with diet alone, having given birth to 11-year intervals in a maternity level 3, and secondly, to study over the same period the evolution of the prevalence of macrosomia. Methods: The variables were collected retrospectively by consulting the selected computerized medical records using PMSI coding. Results: The overall macrosomial rate remained stable in 11 years (5,7% in 2006 vs 6,6% in 2017). There was no significant difference between the 2 populations for most of the classical risk factors. In contrast, the prevalence of GDM increased (4,8% vs 12,6%, p <0,05) and was more often associated with macrosomia in 2017 (12,9% vs 4.8%, p <0,03) and the occurrence of neonatal complications. The term overrun was also more frequent in 2017 (53% vs 34,6%, p <0,005). In addition, in 2017, the macrosomia rate was similar in women without GDM and with GDM treated alone (5,6% vs 5,4%). The macrosomial rate associated with GDM decreased by 20% 2010 to 12,6% in 2017. Thus the reduction of the macrosomia rate, and expected fetal-maternal complications in agreement with the results of the HAPO study, was not found in our study. Conclusion: Since the introduction of the new GDM screening thresholds in 2010, the overall prevalence of macrosomia remains stable but decreases in women with diabetes. However, there is still 5,6% of macrosomia not explained by diabetes.
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Jennifer Valmori. Étude de l'évolution de la prévalence, des facteurs de risques et des complications materno-fœtales de la macrosomie entre 2006 et 2017 à l'Hôpital de la Conception. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02092345⟩

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