Large for Gestational Age Births Among South Indian Women: Temporal Trend and Risk Factors from 1996 to 2010

Abstract

Background/Purpose Mean birth weight is a good health indicator for any population. In the recent past, there have been many reports in the West indicating that there has been an increase in the proportion of large for gestational age (LGA) babies. The objective is to describe the change in the incidence of LGA babies from 1996 to 2010 in South India and the maternal risk factors. Methods A rotational sampling scheme was used, i.e., the 12 months of the year were divided into 4 quarters and a month was from each quarter was selected rotationally. All deliveries for that month were considered. Only deliveries that occurred between 28 and 42 weeks of pregnancy were considered. The association between risk variables was studied using multivariable logistic regression. Results There were 35,718 deliveries that occurred during these 15-year-study period in the gestational age 28-42 weeks were registered through the outpatient clinics. The incidence of LGA was 9.4 % that has mostly Lakshmanan Jeyaseelan is a Professor, Bijesh Yadav is a Senior Demonstrator, Veerasamy Silambarasan is a Research Fellow in the Department of Biostatistics, Reeta Vijayaselvi is a Assistant Professor, Ruby Jose is a Professor and Head in the Obstetrics and Gynaecology Unit IV, Christian Medical College, Vellore, India.Publishing datasets The dataset will not be available for publishing online since further research has been planned. remained at the same level. The incidence of LGA in mothers with gestational diabetes was 6.7, 3 and 17.6 % in overweight, obese and gestational l diabetes mothers. Overweight, obesity in pregnant women and cesarean section were significant risk factors. Conclusion Unlike in Western countries, where the incidence of LGA babies has spiraled upward, has remained nearly at the same level over one and a half decades, in South India. The risk factors for giving birth toLGA babies in South India were similar to other studies.

Regional Gestational Age and Gender-Specific Birth Weight Reference Charts and its Comparison with Existing National and International Standards: A Cross-Sectional Study

“…Hence, extrapolating western data may lead to overdiagnosis of SGA babies and underdiagnosis of LGA babies. A higher proportion of LGA babies in our study as well as in another study by Jeyaseelan et al 12 is also an important finding and gives rise to a very pertinent question, whether this is related to the increasing incidence of obesity in our country. Logistic regression analysis of risk factors associated with SGA revealed oligohydramnios and multiparity as significant risk factors (►Table 4).…”

“…Multivariable logistic regression analysis of independent variables predicting SGA This parameter is set to zero because it is redundant.our data, whereas only 1.5% were LGA by the 90th percentile of Fenton 2013 reference standards. This is also similar to the finding of Jeyaseelan et al, who found that 9.4% of a total 35,718 babies were LGA based on their study data 12. This finding leaves us with a question, whether extrapolating western standards for our babies will lead to overdiagnosis of SGA and underdiagnosis of LGA?…”

High folate intake contributes to the risk of large for gestational age birth and obesity in male offspring

“…Large-for-gestational age (LGA) is defined as a fetal birth weight above 90th percentile for gestational age. During the last few decades, the proportion of infants born with LGA has increased in many populations (Chiavaroli, Castorani, et al, 2016;Jeyaseelan, Yadav, Silambarasan, Vijayaselvi, & Jose, 2016;Lu, Zhang, Lu, Xi, & Li, 2011). As a proxy for intrauterine overgrowth, LGA birth is not only considered to predict negative pregnancy complications, but also a well-established risk factor for overweight or obesity in later life (Mehta, Kruger, & Sokol, 2011;Yu et al, 2011).…”

Macrosomia and large for gestational age in Asia: One size does not fit all

“…In Table 1, the prevalence of macrosomia (> 4000 g) and LGA (>90th percentile) is described for 57 individual country‐time period data points across 16 Asian countries (Bangladesh, 20 Cambodia, 17 Hong Kong, 22–24 India, 17,25–28,111 Indonesia, 20 Japan, 29–39 Korea, 40–47 Malaysia, 48,49 Nepal, 17 Pakistan, 50,51 Philippines, 17 Singapore, 52 Sri Lanka, 17 Taiwan, 53–60 Thailand, 17,61–63 and Vietnam 17,64–66 . In Table 2, the prevalence of macrosomia (> 4000 g) and LGA (>90th percentile) is described for 47 individual data points across China 7,9,17,67–99,112,124 …”