Trends in the Prevalence of Live Macrosomic Newborns According to Gestational Age Strata, in Brazil, 2001–2010, and 2012–2014

Abstract

Keywords► macrosomia ► prevalence ► trends ► epidemiology ► maternal health ► child health AbstractPurpose To describe the trends in the prevalence of macrosomia (birth weight ! 4,000 g) according to gestational age in Brazil in the periods of 2001-2010 and 2012-2014. Methods Ecological study with data from the Brazilian Live Birth Information System (SINASC, in the Portuguese acronym) regarding singleton live newborns born from 22 gestational weeks. The trends in Brazil as a whole and in each of its five regions were analyzed according to preterm (22-36 gestational weeks) and term (37-42 gestational weeks) strata. Annual Percent Changes (APCs) based on the Prais-Winsten method and their respective 95% confidence intervals (CIs) were used to verify statistically significant changes in 2001-2010. Results In Brazil, the prevalence of macrosomic births was of 5.3% (2001-2010) and 5.1% (2012-2014). The rates were systematically higher in the North and Northeast Regions both in the preterm and in term strata. In the preterm stratum, the North Region presented the highest variation in the prevalence of macrosomia (þ137.5%) when comparing 2001 (0.8%) to 2010 (1.9%). In the term stratum, downward trends were observed in Brazil as a whole and in every region. The trends for 2012-2014 were more heterogeneous, with the prevalence systematically higher than that observed for 2001-2010. The APC in the preterm stratum (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) showed a statistically significant trend change in the North (APC: 15.4%; 95%CI: 0.6-32.3) and South (APC: 13.5%; 95%CI: 4.8-22.9) regions. In the term stratum, the change occurred only in the North region (APC:-1.5%; 95%CI: -2.5--0.5).

Macrosomic Newborn Anthropometric Parameters and the Mode of Delivery

“…The incidence of macrosomia varies between 2% to 15% in recent publications [5,18], but an incidence of 20% was found in 2008 in Scandinavia [18]. It is different from one region to another within the same country [7], and even from one hospital to another [19].…”

“…It is often the result of maternal morbidities like diabetes, obesity [2,3], but can also occur without identified maternal morbidity [4]. Its incidence varies between 2% to 15% in recent publications [5,6], and it is increasing in some countries or regions [7,8] while reducing in others [9]. It is still associated with high morbidity and mortality in Sub Saharan Africa [10,11].…”

Foetal macrosomia — incidence, determinants and neonatal outcomes: 10-years retrospective review, 2010–2019

“…Contrary to that, in some countries rising trends in foetal macrosomia has been reversed over the last 2 decades. Current studies reveal the decline in prevalence of macrosomia in United States of America, China and Brazil [1,6,10]. These results have been supported by the improvement of obstetric care, especially management of gestation diabetes [1].…”

Incidence of macrosomia in Mexico: National and subnational estimations

“…In mothers, it is associated with an increased risk of postpartum hemorrhage, prolonged and instrumental delivery, perineal tears, C-sections, prolonged hospitalization, and puerperal infections. Whereas, in newborns, it increases the risk of shoulder dystocia, clavicular fracture, intrauterine hypoxemia, intensive care unit admission, and death [3][4][5][6]. In addition, in the offspring, it increases the risk of chronic non-communicable diseases (NCDs) in adult life, such as cardiovascular diseases, type 2 diabetes mellitus, and obesity [1,7,8].…”