Magnitude and associated factors of fetal macrosomia in a tertiary public hospital, Ethiopia: a cross-sectional study

Fetal macrosomia (birth weight ≥4000g) poses significant maternal and neonatal risks, particularly in low-resource settings. In Ethiopia, factors associated with macrosomia may extend beyond traditional risks. This cross-sectional study aimed to investigate underrecognized factors associated with macrosomia. We conducted a facility-based cross-sectional study at Wolaita Sodo University Comprehensive Specialized Hospital from November 1 to December 30, 2020, involving 467 postpartum women. Data were collected through structured questionnaires and medical record review. Analyses in SPSS 25 included descriptive statistics, bivariate and multivariate logistic regression. Statistical significance was set at p<0.05 with 95% confidence intervals. Macrosomia prevalence was 15.8% across 467 deliveries. Three factors were significantly associated with macrosomia: male fetal sex (AOR=2.71, 95%CI:1.22–5.98), prior macrosomic delivery (AOR=8.53, 95%CI:2.64–27.62), and history of family planning (AOR=3.57, 95%CI:1.30–9.79). Injectable contraceptives accounted for 54% of family planning methods among mothers of macrosomic infants. However, these findings are hypothesis-generating. Longitudinal studies are needed to establish temporality.