Risk factors for recurrent macrosomia and child outcomes

Fang, Fang; Zhang, Qingying; Zhang, Jun; Lei, Xiaoping; Luo, Zhong‐Cheng; Huang, Cheng

doi:10.1007/s12519-019-00249-z

Cited by 30 publications

(26 citation statements)

References 35 publications

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“…Mahony et al reported that 32% of women who delivered first-pregnancy macrosomia might deliver second-pregnancy macrosomia [ 17 ]. We found that the recurrence rate of macrosomia in multipara was 27.2%, which was in accordance with a study conducted by Fang et al with a recurrence rate of 23.2% [ 18 ]. Macrosomia recurrence is of growing concern under the new fertility policy in China as most of the risk factors of macrosomia persist or become even worse in the subsequent pregnancy, and history of macrosomia is one of the most significant risk factors for macrosomia in multipara.…”

Section: Discussionsupporting

confidence: 92%

“…Clinically, identifying multipara who are more likely to deliver macrosomia might be important in planning future pregnancies and preconception counseling for high-risk women and it has been reported that prepregnancy BMI and gestational weight gain were risk factors of macrosomia that were most amenable to intervention, and had potential health benefits beyond pregnancy and childbirth. Therefore, women should maintain their prepregnancy BMI in a normal range before planning to fall pregnant again [ 18 ]. In addition, more intensive behavioral and dietary interventions, together with weight gain control and monitoring, might be needed in high-risk multipara to minimize the risk of macrosomia.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…We discovered that women in the GDM‐dysfunction and GDM‐mixed groups had higher levels of FBG, which might be the reason for their heightened risk of having LGA infants. Several clinical studies have shown that perinatal and long‐term offspring outcomes in GDM women were directly related to glycemic and lipid control during pregnancy, 21‐24 consistent with our findings.…”

Section: Discussionsupporting

confidence: 91%

Contribution of gestational diabetes mellitus heterogeneity and prepregnancy body mass index to large‐for‐gestational‐age infants—A retrospective case‐control study

Wang

Song

Sun

et al. 2020

Journal of Diabetes

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Objective To study the associations between heterogeneity of gestational diabetes mellitus (GDM) subtype/prepregnancy body mass index (pre‐BMI) and large‐for‐gestational‐age (LGA) infants of Chinese women. Methods We performed a retrospective case‐control study of 299 women with GDM and 204 women with normal glucose tolerance (NGT), using oral glucose tolerance test‐based indices performed at 24‐25 weeks of gestation. Women with GDM were classified into the following three physiologic subtypes: GDM with a predominant insulin‐secretion defect (GDM‐dysfunction), GDM with a predominant insulin‐sensitivity defect (GDM‐resistance), or GDM with both defects (GDM‐mixed). We then used a binary logistic regression model to evaluate the potential associations of GDM subtypes and pre‐BMI with newborn macrosomia or LGA. Results Women with GDM‐resistance had a higher pre‐BMI (P < 0.001), whereas women in the GDM‐dysfunction and GDM‐mixed groups had pre‐BMIs comparable to the NGT group. In the logistic regression model, women in the GDM‐mixed group exhibited an increased risk of bearing newborns with macrosomia and LGA, and women in the GDM‐dysfunction group tended to have newborns with LGA after adjusting for pre‐BMI and other potential confounders. Women who were overweight or obese prepregnancy manifested an increased risk of having newborns with macrosomia and LGA relative to normal‐weight women, regardless of whether values were unadjusted or adjusted for all potential confounders. There was no significant interaction between GDM subtype and pre‐BMI for any of the studied outcomes. Conclusions Heterogeneity of GDM (GDM‐dysfunction and GDM‐mixed) and prepregnancy overweight/obesity were independently associated with LGA in Chinese women. There was no significant interaction between GDM subtypes and pre‐BMI for LGA.

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“…Data from a prospective cohort study including 54,371 singleton pregnancies at 12 centers in the US showed that women who had delivered a macrosomic newborn in the past had a high risk to have another macrosomia in the subsequent pregnancy with the recurrence rate of 23.2% (95% CI: 21.2%-25.2%), and the number of prior macrosomic infants was positively associated with the risk of recurrent macrosomia 22 . Previous studies demonstrated that the previous delivery of macrosomia was the single strongest individual risk factor for macrosomia controlling for prepregnancy BMI, excess weight gain, DM/GDM and other risk factors 19 ; 20 .…”

Section: Discussionmentioning

confidence: 99%

Nomogram-Based Prediction of the Risk of Macrosomia: A Prospective Cohort Study in a Chinese Population

Chai

Zhao

et al. 2021

Preprint

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Objective: This study aimed to establish a nomogram for predicting the risk of macrosomia in early pregnancy.Methods: We performed a prospective cohort study involving 1,549 pregnant women. According to the birth weight of newborn, the subjects were divided into two groups: macrosomia group and non-macrosomia group. Multivariate logistic regression was used to analyze the risk factors for macrosomia.Results: The prevalence of macrosomia was 6.13% (95/1549) in our hospital. Multivariate logistic regression analysis showed the risk factors of macrosomia were prepregnancy overweight (OR: 2.126, 95% CI: 1.181-3.826)/obesity (OR: 3.536, 95% CI: 1.555-8.036), multiparity (OR:1.877, 95% CI: 1.160-3.039), the history of macrosomia (OR: 36.971, 95% CI: 19.903-68.674), the history of GDM/DM (OR: 2.285, 95% CI: 1.314-3.976), the higher levels of HbA1c (OR: 1.763, 95% CI: 1.004-3.097) and TC (OR: 1.360, 95% CI: 1.004-1.842). A nomogram was developed for predicting macrosomia based on maternal factors related to the risk of macrosomia in early pregnancy. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.807 (95% CI: 0.755–0.859), the sensitivity and specificity of the model were 0.716 and 0.777, respectively.Conclusion: The nomogram model provides an accurate mothed for clinicians to early predict macrosomia.

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Risk factors for recurrent macrosomia and child outcomes

Cited by 30 publications

References 35 publications

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

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

Contribution of gestational diabetes mellitus heterogeneity and prepregnancy body mass index to large‐for‐gestational‐age infants—A retrospective case‐control study

Nomogram-Based Prediction of the Risk of Macrosomia: A Prospective Cohort Study in a Chinese Population

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