Antenatal risk factors associated with neonatal morbidity in large‐for‐gestational‐age infants: an international prospective cohort study

Vieira, Matias C.; McCowan, Lesley; North, Robyn A.; Myers, Jenny; Walker, James J.; Baker, Philip N.; Dekker, Gustaaf A.; Kenny, Louise C.; Poston, Lucilla; Pasupathy, Dharmintra

doi:10.1111/aogs.13362

Cited by 11 publications

(6 citation statements)

References 36 publications

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“…Large-for-gestational-age (LGA), which is defined as a birth weight above the 90th centile, is associated with increased perinatal mortality and morbidity,1–3 future risk of developing obesity and insulin resistance 4–6. LGA increases the risk of shoulder dystocia and neonatal intensive care unit admission, and maternal risks include higher caesarean section rates, postpartum haemorrhage and third-degree and fourth-degree tears 7–9. Several studies have suggested that prenatal identification of LGA and appropriate management of delivery in suspected LGA infants are effective preventive measures to prevent delivery‐related perinatal morbidity 7 10.…”

Section: Introductionmentioning

confidence: 99%

Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study

2020

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ObjectivesThere is no consensus regarding a possible relation between false positive glucose challenge test (GCT) results and large-for-gestational-age (LGA) infants. This study aimed to clarify the association between false positive GCT results and LGA, after adjusting for potential confounding factors, using a large clinical dataset.DesignRetrospective cohort study.SettingNational Hospital Organisation Kofu National Hospital, which is a community hospital, between January 2012 and August 2019.ParticipantsJapanese women who underwent GCT between 24 and 28 weeks of gestation at the hospital were included. After excluding those with gestational diabetes mellitus, diabetes in pregnancy and multiple pregnancies, subjects were divided into a false positive GCT group (≥140 mg/dL) and a GCT negative group (<140 mg/dL).MethodsObstetric records of patients were examined. The χ2-test and multivariable logistic regression analysis were used to investigate the association between false positive GCT results and LGA.Primary and secondary outcome measuresIncidence of LGA and the association between false positive GCT results and LGA.ResultsThe mean subject age was 31.4±5.5 years, with 43.3% nulliparity (n=974) and 2160 (96.1%) term deliveries. The incidence of LGA was 9.4% (211/2248) and 11.4% (257/2248) of the women had false positive GCT results. False positive GCT results were significantly associated with an increased risk of LGA (OR, 1.51; 95% CI, 1.02 to 2.23), after controlling for maternal age, prepregnancy maternal weight, maternal weight gain during pregnancy and parity.ConclusionsIt appears that there is a significant association between false positive GCT results and LGA. Additional research is required to confirm these results and to investigate appropriate interventions for women with abnormal screens for gestational diabetes mellitus.

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Section: Introductionmentioning

confidence: 99%

Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study

2020

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“…Mothers of LGA or macrosomic (birthweight greater than 4.0–4.5 kg) babies are at higher risk of intrapartum complications (prolonged labour, assisted vaginal birth, emergency caesarean section, shoulder dystocia, perineal trauma and haemorrhage), and possibly stillbirth. The babies have greater risk of neonatal complications (low Apgar score, neonatal unit admission, neonatal trauma, transient tachypnoea, hyperbilirubinaemia or hypoglycaemia) 1–6 …”

Section: Introductionmentioning

confidence: 99%

“…The babies have greater risk of neonatal complications (low Apgar score, neonatal unit admission, neonatal trauma, transient tachypnoea, hyperbilirubinaemia or hypoglycaemia). [1][2][3][4][5][6] Unlike the universal screening programmes for fetuses that are small for gestational age (SGA), guidelines on antenatal care do not recommend routine screening for LGA. 7,8 Conversely, serial ultrasound fetal growth assessment is recommended for women with diabetes or with a body mass index (BMI) of ≥35.0 kg/m 2 in pregnancy, [9][10][11] both associated with LGA.…”

Section: Introductionmentioning

confidence: 99%

Antenatal detection of large‐for‐gestational‐age fetuses following implementation of the Growth Assessment Protocol: secondary analysis of a randomised control trial

Relph

Vieira

Copas

et al. 2023

BJOG

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Objective: To determine whether the Growth Assessment Protocol (GAP) affects the antenatal detection of large for gestational age (LGA) or maternal and perinatal outcomes amongst LGA babies. Design: Secondary analysis of a pragmatic open randomised cluster control trial comparing the GAP with standard care. Setting: Eleven UK maternity units. Population: Pregnant women and their LGA babies born at ≥36 +0 weeks of gestation. Methods: Clusters were randomly allocated to GAP implementation or standard care. Data were collected from electronic patient records. Trial arms were compared using summary statistics, with unadjusted and adjusted (two-stage cluster summary approach) differences.

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“…Maternal diabetes, uncontrolled diabetes, excessive weight gain during pregnancy, a history of macrosomia in a previous pregnancy, gestational diabetes mellitus (GD), obesity, excessive gestational weight gain, and postterm pregnancy are risk factors for infant macrosomia (6,7). Macrosomic children born to non-diabetic mothers may be at risk due to maternal obesity and genetics (7).…”

Section: Introducti̇on and Ai̇mmentioning

confidence: 99%

Early Mortality And Morbidity Analysis Of Macrosomic Newborn Babies

tosun,

Salihoğlu

2023

Preprint

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Introduction: Macrosomia is defined by birth weight (BW) ≥ 4000 g, with prevalence ranging from 0.9–15% in all births. In 6.21% of term babies, DA ≥ 2500g was recorded. Term macrosomic neonates had a greater risk of neonatal early morbidity (labor-induced, cardiorespiratory, metabolic, hematological, morphological, and functional) and death than term AGA babies. Early morbidity and death in term macrosomic babies were our study's focus. Method: Newborns ≥ 2500 g from singleton pregnancies at 37–42 weeks were assessed for postnatal morbidity and death from January 2022 to June 2023. The research group consisted of babies ≥ 4000 g, whereas the control group consisted of neonates 2500–3999 g. The Clinical Research Ethics Committee approved. We moved clinical data to the computerized environment. We utilized NCSS 2020 Statistical Software. Results were assessed using a 95% confidence interval and a significance threshold of p < 0.05. The study found 4.09% (43 out of 1052) macrosomia cases. The study group had a mean birth weight of 4.2 kg with a standard deviation of 0.19 kg, whereas the control group had 3.2 kg with 0.34 kg. A substantial positive connection was found between mothers' pregnancy weight and baby birth weight, with a p-value of less than 0.05. During the first 15 minutes after delivery, the research group had substantially higher systolic and diastolic blood pressures (p < 0.05). The research group showed a substantial drop in blood sugar levels in the first postnatal hour (p < 0.01). In the macrosomic sample, insufficient postnatal care (66.6%) and the necessity for cesarean birth owing to CPD were significantly higher (p < 0.05). Morbidity differences across groups were not significant (p > 0.05). The inquiry found no deaths. Results: This research found macrosomia at the same rate as previous studies. Pregnancies without monitoring were more common in the macrosomic group than the control cohort. Mothers' prenatal weight was positively correlated with infant birth weight. The macrosomic cohort had more cesarean sections due to cephalopelvic disproportion (CPD). Birth weight was linked to a reduction in blood sugar within an hour. In the first hour, macrosomic participants had significantly lower blood glucose levels than control participants. The macrosomic group had substantially higher noninvasive arterial systolic/diastolic blood pressures in the delivery room for 15 minutes after birth.

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Antenatal risk factors associated with neonatal morbidity in large‐for‐gestational‐age infants: an international prospective cohort study

Abstract: Regular physical activity in mid-pregnancy is associated with lower risk for neonatal morbidity in large-for-gestational-age infants and seems to offer protection against the increased risk associated with higher maternal glucose levels.

Cited by 11 publications

References 36 publications

Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study

Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study

Antenatal detection of large‐for‐gestational‐age fetuses following implementation of the Growth Assessment Protocol: secondary analysis of a randomised control trial

Early Mortality And Morbidity Analysis Of Macrosomic Newborn Babies

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