Association of large for gestational age with cardiovascular metabolic risks: a systematic review and meta‐analysis

Abstract

Objective The aim of this study was to clarify the relationships among large for gestational age (LGA) and cardiometabolic risk factors. Methods PubMed, Web of Science, and the Cochrane Library databases were searched to identify studies on LGA and outcomes of interest, including BMI, blood pressure, glucose metabolism, and lipid profiles. Data were independently extracted by two reviewers. A meta‐analysis was performed using a random‐effects model. The Newcastle‐Ottawa Scale and funnel graph were used to assess the quality and publication bias, respectively. Results Overall, 42 studies involving 841,325 individuals were included. Compared with individuals born appropriate for gestational age, individuals born LGA had higher odds of overweight and obesity (odds ratios [OR] = 1.44, 95% CI: 1.31‐1.59), type 1 diabetes (OR = 1.28, 95% CI: 1.15‐1.43), hypertension (OR = 1.23, 95% CI: 1.01‐1.51), and metabolic syndrome (OR = 1.43, 95%; CI: 1.05‐1.96). No significant difference was found in hypertriglyceridemia and hypercholesterolemia. Stratified analyses showed that, compared with individuals born appropriate for gestational age, individuals born LGA had higher odds for overweight and obesity from toddler age to puberty age (toddler age: OR = 2.12, 95% CI: 1.22‐3.70; preschool: OR = 1.81, 95% CI: 1.55‐2.12; school age: OR = 1.53, 95% CI: 1.09‐2.14; puberty: OR = 1.40, 95% CI: 1.11‐1.77). Conclusions LGA is associated with increased odds of obesity and metabolic syndrome later in life. Future studies should focus on elucidating the potential mechanisms and identifying risk factors.

Blood pressure and lipid profiles in children born after ART with frozen embryo transfer

“…In line with previous studies, we found significantly higher birthweight in the FET group compared with children born after fresh-ET and NC for both sexes ( Maheshwari et al , 2018 ). The association between birthweight and BP later in life is U-shaped ( Gerber and Stern, 1999 ), and a recent meta-analysis revealed an association between LGA and increased childhood BP ( Zhang et al , 2023 ). This association may be caused by the well-documented association between high birthweight/LGA and obesity ( Matthews et al , 2017 ; Kapral et al , 2018 ; Derraik et al , 2020 ), and obesity and hypertension ( Drozdz et al , 2021 ).…”

“…However, studies indicate that children born after FET, especially those born after FET cycles with hormone replacement therapy (HRT-FET) are more prone to adverse obstetric and neonatal outcomes, such as hypertensive disorders in pregnancy, pre-eclampsia, post-partum haemorrhage, caesarean section, and high birthweight ( Asserhøj et al , 2021 ; Moreno-Sepulveda et al , 2021 ; Rosalik et al , 2021 ; Busnelli et al , 2022 ), compared with children born after FET in a natural cycle (NC-FET). Further, children born after FET have an increased risk of being born with a high birthweight and large for gestational age (LGA) compared with children born after both fresh-ET and NC ( Berntsen and Pinborg, 2018 ; Terho et al , 2021 ; Westvik-Johari et al , 2021 ), which may pose an elevated risk of adverse cardiometabolic outcomes later in life ( Zhang et al , 2023 ).…”

Comparison of singleton and twin birth weight reference percentile curves by gestational age and sex in extremely preterm infants: a population-based study

“…1 2 In comparison to AGA infants, LGA infants are at risk for overweight and obesity, hypertension and metabolic syndrome. 3 Identifying high-risk newborns with abnormal growth effectively and accurately plays an important role in prognosis assessment and early intervention.…”