Discussion
In this large cohort of privately insured patients, macrosomia was more common than in the general U.S. population. Within the cohort, advanced gestational age, white race and maternal age 30— 39 were significant risk factors for macrosomia. Women delivering macrosomic infants had an increased risk of a number of adverse outcomes, including increased cesarean birth, shoulder dysto- cia, chorioamnionitis, fourth-degree perineal lac- erations, and postpartum hemorrhage. Even among women delivering vaginally, there was a longer hospital stay associated with delivering a macro- somic infant.