Risk factors combine in a complex manner in assessment for macrosomia

• Published in: BMC public health Vol. 23; no. 1; pp. 271 - 11
• Main Authors: Wang, Yi-Wen, Chen, Yan, Zhang, Yong-Jun
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.02.2023; BioMed Central; BMC
• Subjects: Age; Babies; Birth Weight; Births; Blood pressure; Body Mass Index; Body weight; Childbirth & labor; Combined effect; Community colleges; Cross-Sectional Studies; Diabetes mellitus; Diabetes, Gestational - epidemiology; Diagnosis; Disease; Eclampsia; Ethics; Female; Females; Fetal macrosomia; Fetal Macrosomia - complications; Fetal Macrosomia - epidemiology; Fetuses; Gestational diabetes; Glucose; Hospitals; Humans; Hypertension; Hypertension, Pregnancy-Induced; Infant, Newborn; Macrosomia; Menstruation; Neonates; Obesity; Obesity - epidemiology; Overweight; Overweight - epidemiology; Plasma; Preeclampsia; Pregnancy; Pregnancy Complications - epidemiology; Public health; Regression analysis; Review boards; Risk factor; Risk Factors; Synergistic effect; Weight Gain; Womens health; China; Combined effect; Risk factor; Macrosomia
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-023-15195-9

Macrosomia is a serious public health concern. This study aimed to examine the combined effects of various risk factors on macrosomia. The China Labor and Delivery Survey was a multicenter cross-sectional study that included 96 hospitals. Logistic regression analysis was performed to examine the combined effects of the risk factors for macrosomia. The population attributable risk percentage (PAR%) was calculated for the risk factors. A total of 64,735 live births, including 3,739 neonates with macrosomia, were used for the analysis. The weighted prevalence of macrosomia was 5.8%. Pre-pregnancy overweight/obesity, diabetes, and gestational hypertension have a synergistic effect on increasing the rate of macrosomia in mothers aged < 36 years. The highest odds ratio (36.15, 95% CI: 34.38-38.02) was observed in female fetuses whose mothers had both gestational hypertension and diabetes. However, in mothers aged ≥ 36 years, the synergistic effect of gestational hypertension and other factors did not exist, and the risk for macrosomia was reduced by 70% in female fetuses of mothers with both gestational hypertension and overweight/obesity. Pre-pregnancy risk factors (pre-pregnancy overweight/obesity and advanced maternal age) contributed the most to macrosomia (23.36% of the PAR%), and the single largest risk factor was pre-pregnancy overweight/obesity (17.43% of the PAR%). Macrosomia was related to several common, modifiable risk factors. Some factors have combined effects on macrosomia (e.g., pre-pregnancy overweight/obesity and diabetes), whereas gestational hypertension varies by maternal age. Strategies based on pre-pregnancy risk factors should be given more attention to reduce the burden of macrosomia.