Secular trends of macrosomia in southeast China, 1994-2005

Abstract

BackgroundThe rate of macrosomia (birth weight≥4, 000 g) increased over the past four decades in many parts of the world. Macrosomia is associated not only with higher risks of maternal and neonatal complications but also with health risks in adulthood. We examined trends in neonatal macrosomia and large-for-gestational-age (LGA) births among singleton, live, term and postterm births (≥37 complete weeks' gestation) in southeast China from 1994 to 2005 and explored possible causes of the temporal trends.MethodsData from Perinatal Health Care Surveillance System in 12 cities and counties in southeast China were analyzed for trends in birth weight, neonatal macrosomia and LGA from 1994 to 2005. A total of 594, 472 singleton live births were included. We conducted multiple logistic regression analyses to relate these trends to changes in maternal and pregnancy characteristics.ResultsThe rate of macrosomia rose from 6.00% in 1994 to 8.49% in 2000 and then levelled off to 7.83% in 2005. Similar trends were observed in mean birth weight. The incidence of LGA births increased continuously from 13.72% in 1994 to 18.08% in 2000, but the LGA rate remained relatively stable from 2002 to 2005. There was a decrease in gestational age and a significant increase in frequency of prelabor caesarean delivery from 1994 to 2005. In an adjusted multivariable model, the increase in LGA rate from 1994 to 2000 was associated with increasing net gestational weight gain, maternal age, maternal height and maternal education. But they didn't fully explain the increase. The trends of 2002-2005 LGA declined after adjusted for maternal and neonatal characteristics.ConclusionsIn southeast China, the incidence of macrosomia increased from 1994 to 2000 was mainly related to increasing net gestational weight gain. The incidence of macrosomia has levelled off in recent years partly due to increasing use of prelabor caesarean delivery and earlier delivery and partly due to moderation of gestational weight gain.

Secular Trends in Birthweight

“…Both low birthweight and very low birthweight increased during the same period, whereas macrosomia decreased. Similarly, in Southern China, Lu et al [39] found that the rate of macrosomia rose from 6.0% in 1994 to 8.5% in 2000, and subsequently decreased to 7.8% in 2005. Similar turnarounds were observed in mean birthweight trends.…”

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

“…Similarly, in Sweden, from 1992 to 2001, newborn babies weighing over 4500 g increased from 3.7 to 4.6 %, respectively [7]. In China, the incidence of macrosomia, i.e., birth weight [4000 or 4500 g, has increased for the period from 1994 to 2000 [8]. Although babies with larger birth weights are preferred by the lay public, it has been shown that neurological sequelae and perinatal death increased as birth weight of the baby crossed 4000 g [9][10][11].…”

Birth weight and childhood obesity: a 12-country study

“…3 At the same time, a rapidly increased rate of newborn macrosomia has been found in most developed and developing countries in the past two decades. [4][5][6] Several studies have indicated that high birth weight is associated with an increased risk of childhood obesity. [7][8][9][10][11][12][13][14][15][16][17][18][19] However, few studies have examined the extent to which birth weight is associated with obesity in young school children in high-, middle-and low-income countries.…”