Searching for the definition of macrosomia through an outcome-based approach in low- and middle-income countries: a secondary analysis of the WHO Global Survey in Africa, Asia and Latin America

Ye, Jiangfeng; Torloni, Maria Regina; Ota, Erika; Jayaratne, Kapila; Pileggi-Castro, Cynthia; Ortíz-Panozo, Eduardo; Lumbiganon, Pisake; Morisaki, Naho; Laopaiboon, Malinee; Mori, Rintaro; Tunçalp, Özge; Fang, Fang; Yu, Hongping; Souza, João Paulo; Vogel, Joshua P.; Zhang, Jun

doi:10.1186/s12884-015-0765-z

Cited by 64 publications

(70 citation statements)

References 26 publications

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“…Analysis of standardized data across 23 low‐ and middle‐income countries shows clearly that macrosomia, like the association between maternal height and cephalo‐pelvic disproportion, is not a uniform condition across populations (Ye et al, ). Rather, definitions of macrosomia should be tailored to the risks experienced by both mothers and offspring.…”

Section: Revisiting the Obstetrical Dilemmamentioning

confidence: 99%

“…At any given birth weight, Asian populations demonstrate higher maternal and perinatal mortality/morbidity, and a higher risk of cesarean section. Of particular interest is the finding that the birth weight‐associated increase in maternal morbidity/mortality is steeper than that for perinatal morbidity/mortality (Ye et al, ), indicating that when women do have access to cesareans, the penalties of obstructed labour are on average greater for mothers than their offspring. In the absence of cesareans, however, the fetus has a much higher chance of dying.…”

Section: Revisiting the Obstetrical Dilemmamentioning

confidence: 99%

“… Associations between neonatal birth weight categories and the risk of (a) maternal mortality and morbidity (MM), (b) perinatal mortality and morbidity (MM) and (c) intrapartum cesarean section in low‐ and middle‐income countries, stratified by global region. Based on data of Ye et al, .…”

Section: Revisiting the Obstetrical Dilemmamentioning

confidence: 99%

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The New “Obstetrical Dilemma”: Stunting, Obesity and the Risk of Obstructed Labour

Wells

2017

The Anatomical Record

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The "obstetrical dilemma" refers to the tight fit between maternal pelvic dimensions and neonatal size at delivery. Most interest traditionally focused on its generic significance for humans, for example our neonatal altriciality and our complex and lengthy birth process. Across contemporary populations, however, the obstetrical dilemma manifests substantial variability, illustrated by differences in the incidence of cephalo-pelvic disproportion, obstructed labour and cesarean section. Beyond accounting for 12% of maternal mortality worldwide, obstructed labour also imposes a huge burden of maternal morbidity, in particular through debilitating birth injuries. This article explores how the double burden of malnutrition and the global obesity epidemic may be reshaping the obstetrical dilemma. First, short maternal stature increases the risk of obstructed labour, while early age at marriage also risks pregnancy before pelvic growth is completed. Second, maternal obesity increases the risk of macrosomic offspring. In some populations, short maternal stature may also promote the risk of gestational diabetes, another risk factor for macrosomic offspring. These nutritional influences are furthermore sensitive to social values relating to issues such as maternal and child nutrition, gender inequality and age at marriage. Secular trends in maternal obesity are substantially greater than those in adult stature, especially in low-and middle-income countries. The association between the dual burden of malnutrition and the obstetrical dilemma is therefore expected to increase, because the obesity epidemic is emerging faster than stunting is being resolved. However, we currently lack objective population-specific data on the association between maternal obesity and birth injuries. Anat Rec, 300:716-731,

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Section: Revisiting the Obstetrical Dilemmamentioning

confidence: 99%

Section: Revisiting the Obstetrical Dilemmamentioning

confidence: 99%

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The New “Obstetrical Dilemma”: Stunting, Obesity and the Risk of Obstructed Labour

Wells

2017

The Anatomical Record

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“…Senegal, by Thieba et al [21], in Burkina-Faso and by Kakudji et al [12], in Kinshasa (DRC) and also by Cheng et al [5], in China who reported 1.57%, 2.1%, 2.4% and 3.4% respectively. However, our frequency is very lower than those reported by Ananth et al [6], in Canada (24%) between 1992 and 1996 and by Jensen et al [22] in Denmark (28%).…”

Section: Continued Perinatal Outcomesmentioning

confidence: 99%

Trends of Macrosomia at University Clinics of Kinshasa

Andy¹,

Sylvain²,

Rachid³

et al. 2018

OJOG

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Context. The prevalence of macrosomia varies through the world according to racial and ethnic factors, life style and importance of non communicable diseases (maternal obesity, diabetes-gestational and type 2), post-term gestation and multiparity. At the University Clinics of Kinshasa (UCK), 30 years ago, the frequency of macrosomia was 2.4%. Objectives. To update data on the frequency of macrosomia at UCK, regarding variations in maternal anthropometrics (obesity) and socio-demographic factors. Methods. A cross-sectional study was conducted at UCK from 1 January 2007 to 31 December 2016. Mothers who delivered babies weighing at least 4000 g were included in this study. Results. The frequency of macrosomia was 3.7%. Trend shows a variation of this frequency over time with lowest frequency (2.1%) in 2012 and highest (5.3%) in 2009. The mother average age and parity were 32.3 ± 5.4 years and 3 ± 2, respectively. Pregnancies were complicated by polyhydramnios (48%) and gestational diabetes (19.7%). Caesarean section was performed in 60.5% cases, mainly for macrosomia (47.8%) and 81.6% of newborns had constitutional macrosomia. Adverse obstetrical outcomes of macrosomia were dominated by caesarean section (28.9%), lacerations of birth canal (23%) and neonatal distress (9.2%). Conclusion. Macrosomia remains a constant finding at UCK, and is associated with maternal, fetal and neonatal adverse outcomes. Trend shows a variation of the frequency over time between 2.1% and 5.3%.

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“…Though fetal macrosomia has been defined as birth-weight over 4000 g irrespective of gestational age or greater than the 90th percentile for gestational age after correcting for neonatal sex and ethnicity [8], there is currently no consensus in the definition among researchers and obstetricians [9]. It predisposes to prolonged and difficult labor, the consequence of which is a high rate of maternal morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Effect of Alligator Pepper on Litter Weight of Rats Fed on High Glycemic Index Diet

Inegbenebor¹,

Eghomwanre²

2017

FNS

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This study was carried out to find out if alligator pepper can prevent the development of fetal macrosomia in Sprague-Dawley rats fed with high glycemic index diet. Fifteen adult female Sprague-Dawley rats of proven fertility were acclimatized for a period of two weeks in a well-ventilated laboratory and fed with grower's mash and water ad libitum. Thereafter, they were randomly placed in separate cages after which a male Sprague-Dawley rat of proven fertility was introduced into each of the cages containing the female rats. They were left in the cages for three days during, which mating was confirmed to have occurred. The male rats were then withdrawn from the female rats, which were placed in separate maternity cages. The female rats were randomly allocated to three groups A, B and C so there were 5 pregnant rats in each group. The rats in group A were fed with 50 g of grower's mash daily while the rats in groups B and C were fed with 50 g of cooked fermented cassava respectively. All rats were given water ad libitum throughout the duration of the experiment. The rats in groups A and B were intraperitoneally injected with 13.3 ml per Kg body weight of distilled water while the rats in group C were intraperitoneally injected with 13.3 mg/Kg body weight of aqueous extract of alligator pepper respectively. They were observed for 18 -25 days. The litters of the rats in group B had a significantly higher mean weight than the rats in group A while the litters of the rats in group C had a significantly lower mean weight than the rats in groups B. It was concluded that intraperitoneally injected aqueous extract of alligator pepper, in the first trimester of pregnancy, can prevent the development of fetal macrosomia in Sprague-Dawley rats.

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Searching for the definition of macrosomia through an outcome-based approach in low- and middle-income countries: a secondary analysis of the WHO Global Survey in Africa, Asia and Latin America

Cited by 64 publications

References 26 publications

The New “Obstetrical Dilemma”: Stunting, Obesity and the Risk of Obstructed Labour

The New “Obstetrical Dilemma”: Stunting, Obesity and the Risk of Obstructed Labour

Trends of Macrosomia at University Clinics of Kinshasa

Effect of Alligator Pepper on Litter Weight of Rats Fed on High Glycemic Index Diet

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