Excessive Maternal Weight and Diabetes Are Risk Factors for Macrosomia: A Cross-Sectional Study of 42,663 Pregnancies in Uruguay

Abstract

Objective: To evaluate the risk of macrosomia in newborns from women with gestational diabetes, pregestational diabetes, overweight, and obesity in Uruguay in 2012, as well as its association with prolonged pregnancy, maternal age, multiparity, and excessive gestational weight gain (EGWG). Methods: We performed a cross-sectional study of 42,663 pregnant women. The risk of macrosomia was studied using logistic regression. Results: Mean maternal age was 26.7 ± 6.8 years. Pregestational overweight and obesity was present in 20.9% and 10.7% of women, respectively. There were 28.1% and 19.8% of women overweight and obese at the end of the pregnancy, respectively. Furthermore, 0.5% had pregestational diabetes and 8.5% were multiparous. Twenty two percent developed gestational diabetes and 44.9% had EGWG. The prevalence of macrosomia was 7.9%, significantly more prevalent in males (10.0% vs. 5.5%, p<0.005). Univariate analysis showed that obesity and overweight pre-pregnancy, obesity and overweight at the end of pregnancy, EGWG, pregestational diabetes, gestational diabetes, multiparity, prolonged pregnancy, and male newborn were strongly associated with macrosomia (p<0.0001). Maternal age >35 years did not increase the risk of macrosomia. After multiple logistic regression macrosomia was more likely in pre-gestational obese women (OR 1.24;

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

“…Thus, the combinative effect of extra glucose and insulin leads to the increased accumulation of adipose tissue and protein in the fetuses, resulting in fetal accelerated growth and macrosomia (33,34). Pereda et al (29) conducted a cross-sectional study involving 42,663 pregnant women and reported that male fetuses were associated with increased risk of macrosomia (aOR = 1.89, 95% CI: 1.72-2.08), and such association was also found in our study (OR = 1.69, 95% CI: 1.60-1.78) (Table S2). We found that for pregnant women without GDM/GDM history, the protective effect of maternal first-trimester low BMI against macrosomia was the strongest in female infants born in summer and in male infants born in spring and autumn.…”

“…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). Schwartz et al (13) found that multipara had a higher risk of GDM compared with nullipara (73% versus 40%, P < 0.001) based on a meta-analysis of 19,053 singleton participants.…”

Insulin Resistance is a Risk Factor for Early Miscarriage and Macrosomia in Patients With Polycystic Ovary Syndrome From the First Embryo Transfer Cycle: A Retrospective Cohort Study

“…At present, a large number of studies have found that maternal weight was a high-risk factor of macrosomia ( 21 – 24 ). Additionally, a study found that insulin resistance was a link between maternal overweight and fetal macrosomia in nondiabetic pregnancies ( 25 ).…”

Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018

“… 11–13 It is also responsible for prolonging labor, increasing the risk of obstructed labor and cesarean delivery, 14 and has notable effects on the fetus. 12 , 15 , 16 Recent animal experiments have shown that lean and obese animals are typically less fertile, but not necessarily in humans. 17 Few high-quality studies have explored the nonlinear relationship between body mass index and infertility.…”