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目的：探讨巨大儿发病的危险因素。方法2267名住院分娩的孕妇中，136名（5.99%）产下巨大儿（M组），又从全部产妇中随机选出136例未产下巨大儿者作为对照（NM组）。对比分析两组的孕产指标，判定巨大儿发病的危险因素。结果两组的年龄、身高、妊娠期糖尿病发病率等差异无统计学意义（均P>0.05）。M组的经产妇比例、孕前体重指数、孕期体重增长、剖宫产率、产后出血率等均显著高于NM组（均P0.05). The proportion of multiparae, pre-pregnancy body mass index (BMI), weight gain during pregnancy, Cesarean section rate, and postpartum hemorrhage rate of Group M were all significantly higher than those of Group NM (all P<0.05). Multivariate Logistic regression analysis showed that being multipara (OR=8.82, 95%CI:4.09~19.03), pre-pregnancy BMI(OR=1.27, 95%CI:1.11~1.45 ), and weight gain during pregnancy (OR=1.26, 95%CI:1.14~1.38) were the risk factors for macrosomia. Conclusion Being multipara (OR=8.82, 95%CI:4.09~19.03), pre-pregnancy BMI(OR=1.27, 95% CI: 1.11~1.45 ), and weight gain during pregnancy (OR=1.26, 95% CI: 1.14~1.38) are the risk factors for macrosomia. Perinatal body weight management is very important.