Reasons for the increasing incidence of macrosomia in Harbin, China

Bao, Changlin; Zhou, Yulai; Jiang, Lifang; Sun, Chi-Chin; Wang, Fan; Xia, Wei; Han, Fang; Zhao, Yong; Wu, Ling

doi:10.1111/j.1471-0528.2010.02776.x

Cited by 25 publications

(27 citation statements)

References 5 publications

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“…We also found that mothers delivering macrosomic infants were significantly older ( P = 0.000). This finding agrees with most domestic and foreign scholars' reports[10],[19]–[21]. However, Adesina et al [22].…”

Section: Discussionsupporting

confidence: 92%

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Risk factors and long-term health consequences of macrosomia: a prospective study in Jiangsu Province, China

Gu¹,

An²,

Fang³

et al. 2012

J Biomed Res

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We sought to determine risk factors associated with fetal macrosomia and to explore the long-term consequence of infant macrosomia at the age of 7 years. A prospective population based cohort study was designed to examine the associations between maternal and perinatal characteristics and the risk of macrosomia. A nested case-control study was conducted to explore the long-term health consequence of infant macrosomia. The mean maternal age of the macrosomia group was 24.74±3.32 years, which is slightly older than that in the control group (24.35±3.14 years, P = 0.000). The mean maternal body mass index (BMI) at early pregnancy was 22.75±2.81 kg/m2, which was also higher than that in the control group (21.76±2.59 kg/m2, P = 0.000). About 64.6% of macrosomic neonates were males, compared with 51.0% in the control group (P = 0.000). Compared with women with normal weight (BMI: 18.5-23.9 kg/m2), women who were overweight (BMI: 24-27.9 kg/m2) or obese (BMI≥28 kg/m2), respectively, had a 1.69-fold (P = 0.000) and a 1.49-fold (P = 0.000) increased risks of having a neonate with macrosomia, while light weight (BMI<18.5 kg/m2) women had an approximately 50% reduction of the risk. Furthermore, macrosomia infant had a 1.52-fold and 1.50-fold risk, respectively, of developing overweight or obesity at the age of 7 years (P = 0.001 and P = 0.000). Older maternal age, higher maternal BMI at early pregnancy and male gender were independent risk factors of macrosomia. Macrosomic infant was associated with an increased predisposition to develop overweight or obesity at the beginning of their childhood.

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Section: Discussionsupporting

confidence: 92%

“…A rapid increase in the rate of macrosomia has been reported in China. For example, Bao et al [10]. found that the incidence of macrosomia increased from 8.31% in 2001 to 10.50% in 2005 in the city of Harbin.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and long-term health consequences of macrosomia: a prospective study in Jiangsu Province, China

Gu¹,

An²,

Fang³

et al. 2012

J Biomed Res

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“…These findings are consistent with observations from previous studies 13 20 21. Yet emerging evidence suggests that maternal pre-pregnancy obesity is also an important determinant of macrosomia 12 13 22 23. When maternal glucose levels and BMI were simultaneously added into the model as continuous variables, the risk association with BMI did not change, but the risk association with maternal BG levels was significantly attenuated.…”

Section: Discussionsupporting

confidence: 91%

Maternal glucose level and body mass index measured at gestational diabetes mellitus screening and the risk of macrosomia: results from a perinatal cohort study

et al. 2014

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ObjectiveTo examine the impact of maternal blood glucose (BG) level and body mass index (BMI) measured at gestational diabetes mellitus (GDM) screening on the risk of macrosomia.DesignA perinatal cohort of women were followed up from receiving perinatal healthcare to giving birth.SettingBeichen District, Tianjin, China between June 2011 and October 2012.Participants1951 women aged 19–42 years with valid values of BMI and BG level at GDM screening (24–28 weeks gestation), singleton birth and birth weight (BW)>2500 g.Main outcomes and measuresPrimary outcome was macrosomia (BW>4000 g). BG level and BMI were measured at GDM screening.Results191 (9.7%) newborns were macrosomia. The ORs (95% CIs) of macrosomia from multiple logistic regression were 1.14 (1.10 to 1.19, p<0.0001) for BMI and 1.11 (1.01 to 1.23, p=0.03) for BG. When BMI and BG levels (continuous) were modelled simultaneously, the OR for BMI was similar, but significantly attenuated for BG. Areas of receiver operating characteristics (ROC) were 0.6530 (0.6258 to 0.6803) for BMI and 0.5548 (0.5248 to 0.5848) for BG (χ2=26.17, p<0.0001). BG (mmol/L, <6.7, 6.7–7.8 or ≥7.8) and BMI in quintiles (Q1–Q5) were evaluated with BG <6.7 and Q2 BMI as the reference group. The ORs of macrosomia were not statistically different for mothers in Q1 or Q2 of BMI regardless of the BG levels; the ORs for ≥Q3 of BMI were elevated significantly with the highest OR observed in Q5 of BMI and BG levels ≥7.8 (6.93 (2.61 to 18.43), p<0.0001).ConclusionsHigh BMI measured at GDM screening was the most important determinant for risk of macrosomia. These findings suggest that GDM screening may be a critical gestational time point to initiate maternal weight control oriented intervention strategy to lower the risk.

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“…Large‐for‐gestational age (LGA) is the most common complication of GDM, and risk factors for LGA, besides GDM, are related to obesity, gestational age, parity, ethnicity and weight gain during pregnancy (6). Maternal anthropometrics have also been shown to affect fetal size in a general obstetric population (7,8). Sweden has one of the highest immigration rates in the world.…”

Section: Introductionmentioning

confidence: 99%