Risk factors combine in a complex manner in assessment for macrosomia

Abstract

Background Macrosomia is a serious public health concern. This study aimed to examine the combined effects of various risk factors on macrosomia. Methods The China Labor and Delivery Survey was a multicenter cross-sectional study that included 96 hospitals. Logistic regression analysis was performed to examine the combined effects of the risk factors for macrosomia. The population attributable risk percentage (PAR%) was calculated for the risk factors. Results A total of 64,735 live births, including 3,739 neonates with macrosomia, were used for the analysis. The weighted prevalence of macrosomia was 5.8%. Pre-pregnancy overweight/obesity, diabetes, and gestational hypertension have a synergistic effect on increasing the rate of macrosomia in mothers aged < 36 years. The highest odds ratio (36.15, 95% CI: 34.38–38.02) was observed in female fetuses whose mothers had both gestational hypertension and diabetes. However, in mothers aged ≥ 36 years, the synergistic effect of gestational hypertension and other factors did not exist, and the risk for macrosomia was reduced by 70% in female fetuses of mothers with both gestational hypertension and overweight/obesity. Pre-pregnancy risk factors (pre-pregnancy overweight/obesity and advanced maternal age) contributed the most to macrosomia (23.36% of the PAR%), and the single largest risk factor was pre-pregnancy overweight/obesity (17.43% of the PAR%). Conclusion Macrosomia was related to several common, modifiable risk factors. Some factors have combined effects on macrosomia (e.g., pre-pregnancy overweight/obesity and diabetes), whereas gestational hypertension varies by maternal age. Strategies based on pre-pregnancy risk factors should be given more attention to reduce the burden of macrosomia.

Unilateral diaphragmatic paralysis and complete brachial plexus injury in a complex birth injury: A rare case report mimicking Tarlov cyst and review of literature

“…Maternal age over 35 years old is also considered a risk factor for macrosomia 8 . Furthermore, pre‐pregnancy overweight, and obesity contribute to the occurrence of macrosomia 9 . Macrosomia babies are significantly more susceptible to brachial plexus injuries during delivery, with a 20‐fold higher risk compared to babies with normal birth weights 10 .…”

“… 8 Furthermore, pre‐pregnancy overweight, and obesity contribute to the occurrence of macrosomia. 9 Macrosomia babies are significantly more susceptible to brachial plexus injuries during delivery, with a 20‐fold higher risk compared to babies with normal birth weights. 10 A significant concern in preventing brachial plexus palsy is the evident link between this condition and macrosomia in diabetic mothers.…”

Chronic Diseases: A Comprehensive Review of Applications for Prediction of Obesity

“…This allows for earlier and more targeted interventions, potentially preventing the onset of obesity rather than merely attempting to reverse it [28,30,[43][44][45]. Furthermore, predictive analytics can help monitor the effectiveness of prescribed interventions in real-time, allowing for adjustments that improve outcomes [25,39,46,47]. Moreover, as obesity continues to be a…”

“…Obesity, characterized by excessive fat accumulation, poses serious health risks and challenges, but ML offers innovative solutions for both its understanding and management [32,52]. By integrating ML into obesity research, scientists and healthcare providers can analyse large, diverse data sets to identify patterns and predictors of obesity that are not immediately apparent through conventional statistical methods [40,46]. One of the primary applications of ML in the context of obesity is in the development of predictive models [5,13].…”

Neonatal birth weight as a predictor of mode of delivery in singleton term pregnancies at a tertiary level maternity hospital in Urban Mumbai

“…5 Macrosomic babies delivered vaginally were found to be more likely to predispose to adverse-feto-maternal complications like perineal tear, post-partum haemorrhage, anal sphincter injury, need for blood transfusion, asphyxia neonatorum, obstructed labour, birth trauma neonatal hypoglycemia and NICU admission. 6,7 Thus Nguyen et al suggested the need to curate the mode of delivery and consider elective caesarean delivery when foetal macrosomia is known or suspected. 10 While caesarean section reduces the incidence of some of the above mentioned complications associated with vaginal birth in cases of foetal macrosomia, the risks are eliminated entirely.…”