Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study

Li, Guoju; Xing, Yuhan; Wang, Guolan; Zhang, Jun; Wu, Qin; Ni, Wei; Jiao, Na; Chen, Wenjing; Liu, Qing; Gao, Li; Zhang, Zhenhong; Wang, Yao; Xing, Quansheng

doi:10.1186/s12916-021-02046-w

Cited by 15 publications

(10 citation statements)

References 31 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An increased pre-pregnancy BMI and excessive maternal weight gain in pregnancy have been recognized as prerequisites for fetal macrosomia by many researchers [34][35][36][37]. Even a protective effect of low pre-pregnancy BMI in non-diabetic women has been described [38,39]. In our study groups, maternal pre-pregnancy obesity did not correlate with macrosomia, while excessive pregnancy weight gain correlated with large fetuses only when considering both groups and not the GDM category solely.…”

Section: Discussioncontrasting

confidence: 44%

Umbilical Cord Biometry and Fetal Abdominal Skinfold Assessment as Potential Biomarkers for Fetal Macrosomia in a Gestational Diabetes Romanian Cohort

et al. 2022

View full text Add to dashboard Cite

Backgroundand Objectives: Gestational diabetes mellitus (GDM) is a pregnancy-associated pathology commonly resulting in macrosomic fetuses, a known culprit of obstetric complications. We aimed to evaluate the potential of umbilical cord biometry and fetal abdominal skinfold assessment as screening tools for fetal macrosomia in gestational diabetes mellitus pregnant women. Materials and methods: This was a prospective case–control study conducted on pregnant patients presenting at 24–28 weeks of gestation in a tertiary-level maternity hospital in Northern Romania. Fetal biometry, fetal weight estimation, umbilical cord area and circumference, areas of the umbilical vein and arteries, Wharton jelly (WJ) area and abdominal fold thickness measurements were performed. Results: A total of 51 patients were enrolled in the study, 26 patients in the GDM group and 25 patients in the non-GDM group. There was no evidence in favor of umbilical cord area and WJ amount assessments as predictors of fetal macrosomia (p > 0.05). However, there was a statistically significant difference in the abdominal skinfold measurement during the second trimester between macrosomic and normal-weight newborns in the GDM patient group (p = 0.016). The second-trimester abdominal circumference was statistically significantly correlated with fetal macrosomia at term in the GDM patient group with a p value of 0.003, as well as when considering the global prevalence of macrosomia in the studied populations, 0.001, when considering both populations. Conclusions: The measurements of cord and WJ could not be established as predictors of fetal macrosomia in our study populations, nor differentiate between pregnancies with and without GDM. Abdominal skinfold measurement and abdominal circumference measured during the second trimester may be important markers of fetal metabolic status in pregnancies complicated by GDM.

show abstract

Section: Discussioncontrasting

confidence: 44%

Umbilical Cord Biometry and Fetal Abdominal Skinfold Assessment as Potential Biomarkers for Fetal Macrosomia in a Gestational Diabetes Romanian Cohort

et al. 2022

View full text Add to dashboard Cite

show abstract

“…( 27 ) performed a multicenter study based on 276,436 singleton livebirths or fresh stillbirths and demonstrated that higher parity was associated with a significantly increased risk of macrosomia. One possible explanation is that fetuses of nullipara were more likely to be exposed to a different maternal immune environment which might restrict the fetal growth in the uterine ( 28 ). Another possible explanation is that higher parity has been reported to be strictly related to GDM, which played an important role in the development of macrosomia ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Protective Effect of Maternal First-Trimester Low Body Mass Index Against Macrosomia: A 10-Year Cross-Sectional Study

et al. 2022

View full text Add to dashboard Cite

ObjectiveWe aimed to assess whether maternal first-trimester low body mass index (BMI) has a protective effect against macrosomia.MethodsThis was a cross-sectional study from January 1, 2011, to June 30, 2021, and 84,900 participants were included. The predictive performance of maternal first-trimester and parental pre-pregnancy BMI for macrosomia was assessed using the area under the receiver-operating characteristics curve (AUC). Multivariate logistic regression analyses were performed to evaluate the independent effect of maternal first-trimester low BMI on macrosomia. Interactions were investigated to evaluate the potential variation of the effect of first-trimester low BMI across different groups. Furthermore, interactions were also examined across groups determined by multiple factors jointly: a) gestational diabetes mellitus (GDM)/GDM history status, parity, and maternal age; and b) GDM/GDM history status, fetal sex, and season of delivery.ResultsThe proportion of macrosomia was 6.14% (5,215 of 84,900). Maternal first-trimester BMI showed the best discrimination of macrosomia (all Delong tests: P < 0.001). The protective effect of maternal first-trimester low BMI against macrosomia remained significant after adjusting for all confounders of this study [adjusted odds ratios (aOR) = 0.37, 95% CI: 0.32–0.43]. Maternal first-trimester low BMI was inversely associated with macrosomia, irrespective of parity, fetal sex, season of delivery, maternal age, and GDM/GDM history status. The protective effect was most pronounced among pregnant women without GDM/GDM history aged 25 to 29 years old, irrespective of parity (multipara: aOR = 0.32, 95% CI: 0.22–0.47; nullipara: aOR = 0.32, 95% CI: 0.24–0.43). In multipara with GDM/GDM history, the protective effect of low BMI was only observed in the 30- to 34-year-old group (aOR = 0.12, 95% CI: 0.02–0.86). For pregnant women without GDM/GDM history, the protective effect of maternal first-trimester low BMI against macrosomia was the weakest in infants born in winter, irrespective of fetal sex (female: aOR = 0.45, 95% CI: 0.29–0.69; male: aOR = 0.39, 95% CI: 0.28–0.55).ConclusionMaternal first-trimester low BMI was inversely associated with macrosomia, and the protective effect was most pronounced among 25- to 29-year-old pregnant women without GDM/GDM history and was only found among 30- to 34-year-old multipara with GDM/GDM history. The protective effect of maternal first-trimester low BMI against macrosomia was the weakest in winter among mothers without GDM/GDM history.

show abstract

“…We found that apart from a history of macrosomia, a higher prepregnancy BMI and gestational weight gain in the subsequent pregnancy were independent risk factors for macrosomia in multipara, which was consistent with previous studies [ 21 , 22 , 23 , 24 ]. A previous cohort study of 105,768 mother-child pairs [ 25 ] and a 10-year cross-sectional study of 84,900 participants [ 26 ] have reported that maternal low BMI was inversely associated with macrosomia. However, most of the previous studies were conducted on the European and American populations rather than the Chinese population.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Macrosomia in Multipara: A Multi-Center Retrospective Study

et al. 2022

View full text Add to dashboard Cite

The increased incidence of macrosomia has caused an enormous burden after the transition from the almost 40-year one-child policy to the universal two-child policy in 2015 and further to the three-child policy in 2021 in China. However, studies on risk factors of macrosomia in multipara under the new fertility policy in China are limited. We aim to explore the incidence and risk factors for macrosomia in multipara to provide the scientific basis for preventing macrosomia in multipara. A multi-center retrospective study was conducted among 6200 women who had two consecutive deliveries in the same hospital and their second newborn was delivered from January to October 2018 at one of 18 hospitals in 12 provinces in China. Macrosomia was defined as birth weight ≥ 4000 g. Logistic regression models were performed to analyze risk factors for macrosomia in multipara. The incidence of macrosomia in multipara was 7.6% (470/6200) and the recurrence rate of macrosomia in multipara was 27.2% (121/445). After adjusting for potential confounders, a higher prepregnancy BMI, higher gestational weight gain, history of macrosomia, a longer gestation in the subsequent pregnancy were independent risk factors of macrosomia in multipara (p < 0.05). Healthcare education and preconception consultation should be conducted for multipara patients with a history of macrosomia to promote maintaining optimal prepregnancy BMI and avoid excessive gestational weight gain to prevent macrosomia.

show abstract

Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study

Cited by 15 publications

References 31 publications

Umbilical Cord Biometry and Fetal Abdominal Skinfold Assessment as Potential Biomarkers for Fetal Macrosomia in a Gestational Diabetes Romanian Cohort

Umbilical Cord Biometry and Fetal Abdominal Skinfold Assessment as Potential Biomarkers for Fetal Macrosomia in a Gestational Diabetes Romanian Cohort

Protective Effect of Maternal First-Trimester Low Body Mass Index Against Macrosomia: A 10-Year Cross-Sectional Study

Risk Factors for Macrosomia in Multipara: A Multi-Center Retrospective Study

Contact Info

Product

Resources

About