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

Sun, Yu; Zhang, Man; Liu, Ruixia; Wang, Jingjing; Yang, Kai-Chien; Yue, Wentao; Yin, Chenghong

doi:10.3389/fendo.2022.805636

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…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

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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.

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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

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“…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

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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.

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“…13 BMI is a widely recommended index to assess nutritional status in early pregnancy. 32 Although the association of maternal BMI in early pregnancy with adverse consequences is controversial, [33][34][35][36][37] it may be a sign of maternal health or potential fetal abnormalities, such as gestational diabetes, low birth weight, macrosomia, etc. Therefore, this study considered maternal BMI as a confounder in the adjusted LR models and did sensitivity analysis to explore and modify the association of maternal weight increase with CHD in offspring.…”

Section: Possible Reasons and Comparison With Previous Studiesmentioning

confidence: 99%

Association of maternal weight gain in early pregnancy with congenital heart disease in offspring: a China birth cohort study

Wang,

Zhang,

et al. 2024

BMJ Open

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ObjectivesLittle study has reported the association of maternal weight gain in early pregnancy with fetal congenital heart disease (CHD). We aimed to explore the potential relationship based on a China birth cohort while adjusting by multiple factors.DesignCohort study.SettingChina birth cohort study conducted from 2017 to 2021.ParticipantsThe study finally included 114 672 singleton pregnancies in the 6–14 weeks of gestation, without missing data or outliers, loss to follow-up or abnormal conditions other than CHD. The proportion of CHD was 0.65% (749 cases).Primary and secondary outcome measuresAssociation between maternal pre-pregnancy weight gain and CHD in the offspring were analysed by multivariate logistic regression, with the unadjusted, minimally adjusted and maximally adjusted methods, respectively.ResultsThe first-trimester weight gain showed similar discrimination of fetal CHD to that period of maternal body mass index (BMI) change (DeLong tests: p=0.091). Compared with weight gain in the lowest quartile (the weight gain less than 0.0 kg), the highest quartile (over 2.0 kg) was associated with a higher risk of fetal CHD in unadjusted (OR 1.36, 95% CI: 1.08 to 1.72), minimally adjusted (adjusted OR (aOR) 1.29, 95% CI: 1.02 to 1.62) and maximally adjusted (aOR 1.29, 95% CI: 1.02 to 1.63) models. The association remains robust in pregnant women with morning sickness, normal pre-pregnancy BMI, moderate physical activity, college/university level, natural conception or with folic acid (FA) and/or multivitamin supplementation.Conclusions and relevanceAlthough the association of maternal pre-pregnancy weight gain on fetal CHD is weak, the excessive weight gain may be a potential predictor of CHD in the offspring, especially in those with morning sickness and other conditions that are routine in the cohort, such as normal pre-pregnancy BMI, moderate physical activity, college/university level, natural conception or with FA and/or multivitamin supplementation.

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

Cited by 3 publications

References 36 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

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

Association of maternal weight gain in early pregnancy with congenital heart disease in offspring: a China birth cohort study

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