Being Macrosomic at Birth is an Independent Predictor of Overweight in Children: Results from the IDEFICS Study

Abstract

Fetal macrosomia is a risk factor for the development of obesity late in childhood. We retrospectively evaluated the relationship between maternal conditions associated with fetal macrosomia and actual overweight/obesity in the European cohort of children participating in the IDEFICS study. Anthropometric variables, blood pressure and plasma lipids and glucose were measured. Socio-demographic data, medical history and perinatal factors, familiar and gestational history, maternal and/or gestational diabetes were assessed by a questionnaire. Variables of interest were reported for 10,468 children (M/F = 5,294/5,174; age 6.0 ± 1.8 years, M ± SD). The sample was divided in four groups according to child birth weight (BW) and maternal diabetes: (1) adequate for gestational age offspring (BW between the 10th and 90th percentiles for gestational age) of mothers without diabetes (AGA-ND); (2) adequate for gestational age offspring of mothers with diabetes (AGA-D); (3) macrosomic offspring (BW> 90th percentile for gestational age) of mothers without diabetes (Macro-ND); (4) macrosomic offspring of mothers with diabetes (Macro-D). Children macrosomic at birth showed significantly higher actual values of body mass index, waist circumference, and sum of skinfold thickness. In both boys and girls, Macro-ND was an independent determinant of overweight/obesity, after the adjustment for confounders [Boys: OR = 1.7 95 % CI (1.3;2.2); Girls: OR = 1.6 95 % CI (1.3;2.0)], while Macro-D showed a significant association only in girls [OR = 2.6 95 % CI (1.1;6.4)]. Fetal macrosomia, also in the absence of maternal/gestational diabetes, is independently associated with the development of overweight/obesity during childhood. Improving the understanding of fetal programming will contribute to the early prevention of childhood overweight/obesity.

Prevalencia y factores asociados a macrosomía en Perú, 2013

“…En cualquier caso, debido a que la macrosomía se asoció con la obesidad materna, como se ha reportado previamente (19,20) , la reducción de la obesidad puede reducir la macrosomía, disminuyendo así las complicaciones en el parto y el puerperio y las tasas de cesáreas. Además, la reducción de la macrosomía puede contribuir a prevenir el desarrollo de sobrepeso / obesidad en la infancia (21) . Una limitación de nuestro estudio es la variabilidad en la definición de macrosomía.…”

Neuroendocrine adaptations to bariatric surgery

“…Early life, including preconception and intrauterine, can establish predictive adaptation and programming whereby a mismatch between fetal expectation and the actual post natal environment develops, generating obesity and related metabolic disorders. There is clear evidence that both low and high extremes of weight for gestation at birth, babies conceived using in-vitro fertilisation and the offspring born to mothers with type-2 diabetes and gestational diabetes are at risk of obesity and its related metabolic disorders (Dyer and Rosenfeld, 2011;Nadif et al, 2015;Sparano et al, 2013). There is also growing interest in the immediate post natal environment and its subsequent influence on weight trajectory and propensity to develop weight related disease (Kerr et al, 2014;Seach et al, 2010).…”

Analysis of Continuous Glucose Monitoring in Pregnant Women With Diabetes: Distinct Temporal Patterns of Glucose Associated With Large-for-Gestational-Age Infants

“…Among women with pregestational (type 1 or 2) diabetes, macrosomia, or large for gestational age (LGA), is the commonest complication of pregnancy, affecting one in two infants (3)(4)(5)(6)(7)(8). As well as the adverse obstetric (labor complications, perineal tearing, instrumental delivery, and caesarean section) and perinatal (shoulder dystocia, respiratory distress, neonatal hypoglycemia, and stillbirth) outcomes associated with LGA, LGA infants are themselves at increased risk of developing obesity, diabetes, and cardiovascular disease in later life (9)(10)(11)(12)(13).…”