Large for gestational age and macrosomia in pregnancies without gestational diabetes mellitus

Abstract

Objective: This study aims to estimate the prevalence and risk factors of macrosomia and LGA (large for gestational age) in non-GDM (gestational diabetes mellitus) pregnant women in Fuyang, Anhui Province of China.

Methods: A large population-based cohort study was conducted among non-GDM pregnant women aged 18–45 years. Maternal sociodemographic data prior to pregnancy were collected using interviewer-administered standardized questionnaire. Maternal obstetrical delivery records and newborn hospital records were extracted from antenatal care booklets and hospital discharge abstracts. Logistic regression analysis was used to identify the predictors of macrosomia and LGA.

Results: The incidence of macrosomia and LGA was 9.2 and 15.9%, respectively. Mothers ≥35 years of age (aOR 2.75, 95% CI 1.98, 3.80), male neonates (aOR 1.68, 95% CI 1.51, 1.89), overweight and obese (aOR 1.61, 95% CI 1.34, 1.92 and aOR 3.05, 95% CI 2.05, 4.56, respectively) were associated with increased risk of macrosomia. Compared with the less educated mothers, the educated mothers were more likely to have increased risk of macrosomia. IFA (iron and folic acid) supplements intake during pregnancy was more likely to deliver macrosomia or LGA (aOR1.32, 95% CI 1.08, 1.49 and aOR1.42, 95% CI 1.24, 1.61, respectively) as compared with no IFA supplements intake. SCr (serum creatinine concentration) >80 µmol/L was related to decreased risk of macrosomia (aOR 0.73, 95% CI 0.61, 0.86) and LGA (aOR 0.67, 95% CI 0.59, 0.77) as compared with normal range (44–80 µmol/L).

Conclusions: There was a high prevalence of macrosomia and LGA in non-GDM pregnant women in China. Healthcare educations and reasonable body weight are necessary for pregnant women to prevent macrosomia and LGA. Pregnant women should be checked regularly and have the first prenatal visit as soon as possible.

Keywords:

• Large for gestational age
• LGA
• macrosomia
• prevalence
• risk factor

Availability of data and materials

The data sets supporting the results of this article are held by the Population and Family Planning Commission of Anhui Province and will be available upon request after approval.

Ethical approval

This study was granted by the Anhui Science and Technology Department and the Research Ethics Committee of Anhui Medical University in June 2006 (#060230060). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki Declaration and its later amendments or comparable ethical standards. All participants provided informed consent, and approval to conduct the survey.

Consent for publication

All authors have read and approved the submission.

Acknowledgements

The authors are grateful to thank all those who contributed to the study design and implementation, including the regional Reproductive Health Working Group for their supports and collaboration throughout the study; the participants especially those women for their cooperation who agreed to participate in the different phases of data collection. We also acknowledge the efforts of all our interviewers, gynecological doctors, laboratory technicians, and health workers in this study.

Disclosure statement

The authors declare that they have no competing interest.

Additional information

Funding

This study was supported by Anhui Provincial Natural Science Foundation [1208085MH143] and the Nature Science Foundation of the Anhui Provincial Higher Education Institutions of China [KJ2017A187] and the Funding of Excellent Talents in Colleges and Universities of Anhui Province, China [gxbjZD07].