The combination of symphysis-fundal height and abdominal circumference as a novel predictor of macrosomia in GDM and normal pregnancy

Chen, Zhi Guo; Xu, Ya; Ji, Lü; Zhang, Xiao Li; Chen, Xiao Xing; Liu, Rui; Wu, Chao; Wang, Yan Ling; Hu, Han; Wang, Lin

doi:10.1186/s12884-020-03157-7

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…What is striking in this study is the high rate of emergency and non-elective caesarean section testifying of the late detection of macrosomia, probably during labor. This reinforces the need for good clinical follow-up by regular measurement of symphysis fundal height associated to abdominal circumference [21]. In addition, the absence of influence of third term ultrasonography to predict macrosomia in our study is consistent with previous reports in the literature and emphasizes the need to use a multiparametric ultrasound model including umbilical vein flow for optimal performance and accuracy to diagnose macrosomia [22] [23].…”

Section: Discussionsupporting

confidence: 91%

Outcomes of Fetal Macrosomia and Associated Factors: A Case-Control Facility Based Study

Nlend¹,

Gwodog²,

Sandie³

2023

OJPed

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Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and mothers with perinatal complications) and controls (pairs free of perinatal complication) of singleton live births were extracted from the maternity registry from January 2017 to December 2019. Matching was done for sex and gestational age after exclusion of genetic cause of macrosomia. The main primary outcome was the risk factors for complications. Logistic regression was used to estimate the odds ratio and the magnitude of association between the primary endpoint and the different covariates of the study. Results: Out of 362 couples included, we had 186 cases and 176 controls. The main perinatal complications were the delivery by caesarean section (26.5%) and lesions of the genital canal, 20.2%. There were no maternal deaths. Among newborns, metabolic complications (19.6%) were a leading cause of harmful outcomes before respiratory complications (12.4%), dystocic presentations (6.3%) or traumatic injuries (1.7%). The neonatal case fatality rate was 2.8%. Maternal age ≥30 years (p = 0.024); non-screening for gestational diabetes (p = 0.027); history of caesarean section (p = 0.041); weight gain ≥16 kg (p < 0.001); maternal HIV (p = 0.047); birth weight ≥4500 g (p = 0.015) and birth height ≥52.7 ± 1.7 cm (p = 0.026) were risk factors for perinatal adverse outcomes. Conclusion: The delivery of a macrosomic baby remains problematic in this setting, and emphasizes the need to improve routine screening of gestational diabetes within a quality of prenatal follow-up through a multidisciplinary perinatal team involving obstetricians, endocrinologists and neonatal pediatricians.

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Section: Discussionsupporting

confidence: 91%

Outcomes of Fetal Macrosomia and Associated Factors: A Case-Control Facility Based Study

Nlend¹,

Gwodog²,

Sandie³

2023

OJPed

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“…Studies have demonstrated that pregnant women complicated with GDM are more likely to deliver macrosomia [ 29 , 30 ]. However, in the current study, we demonstrated that GDM was not significantly associated with the risk of macrosomia in multipara, which might be due to the One-Day Care Clinic for pregnancies with GDM in our study centers.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Macrosomia in Multipara: A Multi-Center Retrospective Study

et al. 2022

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The increased incidence of macrosomia has caused an enormous burden after the transition from the almost 40-year one-child policy to the universal two-child policy in 2015 and further to the three-child policy in 2021 in China. However, studies on risk factors of macrosomia in multipara under the new fertility policy in China are limited. We aim to explore the incidence and risk factors for macrosomia in multipara to provide the scientific basis for preventing macrosomia in multipara. A multi-center retrospective study was conducted among 6200 women who had two consecutive deliveries in the same hospital and their second newborn was delivered from January to October 2018 at one of 18 hospitals in 12 provinces in China. Macrosomia was defined as birth weight ≥ 4000 g. Logistic regression models were performed to analyze risk factors for macrosomia in multipara. The incidence of macrosomia in multipara was 7.6% (470/6200) and the recurrence rate of macrosomia in multipara was 27.2% (121/445). After adjusting for potential confounders, a higher prepregnancy BMI, higher gestational weight gain, history of macrosomia, a longer gestation in the subsequent pregnancy were independent risk factors of macrosomia in multipara (p < 0.05). Healthcare education and preconception consultation should be conducted for multipara patients with a history of macrosomia to promote maintaining optimal prepregnancy BMI and avoid excessive gestational weight gain to prevent macrosomia.

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“…Gestational diabetes mellitus (GDM) is a common complication during pregnancy, and macrosomia is one of the major adverse pregnancy outcomes of GDM ( 1 ). Insulin-like growth factor 2 (IGF2) encodes a polypeptide that is abundant in fetal tissues and circulation ( 2 ), is usually expressed in fetal tissue and invasive trophoblast cells at the placental maternal-fetal interface ( 3 ) and is the major insulin-like growth factor that plays a growth-promoting role during the process of embryonic development ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Overexpression of IGF2 affects mouse weight and glycolipid metabolism and IGF2 is positively related to macrosomia

et al. 2023

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ObjectiveTo investigate the effects of insulin-like growth factor 2 (IGF2) on growth and glycolipid metabolism, as well as the underlying mechanism.MethodsA mouse model of IGF2 overexpression was constructed to measure weight gain before adulthood, to obtain the values of adult glycolipid metabolism indicators in the peripheral blood and to detect the expression of genes in the IGF2 signaling pathway in different mouse tissues. The present study also explored the independent association between the IGF2 gene and macrosomia by detecting and comparing the expression levels of IGF2 mRNA/H19 RNA in maternal peripheral blood and fetal cord blood of 26 human pregnancies.ResultsIn the mouse model, weights of the IGF2-overexpressing mice were significantly higher than those of the control mice at the age of 5-10 weeks. The glucose concentration, total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels of IGF2-overexpressing mice were significantly lower than those of wild-type (WT) mice. Compared with the WT mice, the expression of H19 was significantly decreased in the pancreas and IGF1R was significantly decreased in the muscle of mice with IGF2 overexpression. The expression levels of STAT3 and AKT2 showed significant decrease in liver, muscle and increase in muscle of IGF2-overexpressing mice, respectively. GLUT2 expression showed significant increase in liver, kidney, muscle and decrease in pancreas of mice with IGF2 overexpression. This study also found that in normal mothers with the similar clinical characteristics, IGF2 expression in the maternal peripheral blood and fetal cord blood is an independent factor influencing macrosomia. ConclusionIGF2 expression was independently correlated with the occurrence of macrosomia, and overexpression of IGF2 significantly increased the weights of mice at the age of 5-10 weeks and significantly affected the values of adult glycolipid metabolism indicators, which might be the result of changes in the IGF2-IGF1R-STAT3/AKT2-GLUT2/GLUT4 pathway. These findings might suggest that IGF2 plays an important role in growth and glycolipid metabolism during both pregnancy and postnatal development.

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The combination of symphysis-fundal height and abdominal circumference as a novel predictor of macrosomia in GDM and normal pregnancy

Cited by 4 publications

References 22 publications

Outcomes of Fetal Macrosomia and Associated Factors: A Case-Control Facility Based Study

Outcomes of Fetal Macrosomia and Associated Factors: A Case-Control Facility Based Study

Risk Factors for Macrosomia in Multipara: A Multi-Center Retrospective Study

Overexpression of IGF2 affects mouse weight and glycolipid metabolism and IGF2 is positively related to macrosomia

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