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Archives of Gynecology and Obstetrics

, Volume 298, Issue 4, pp 725–730 | Cite as

Birthweight and large for gestational age trends in non-diabetic women with three consecutive term deliveries

  • Liran Hiersch
  • Shiri Shinar
  • Nir Melamed
  • Amir Aviram
  • Eran Hadar
  • Yariv Yogev
  • Eran Ashwal
Maternal-Fetal Medicine
  • 26 Downloads

Abstract

Objective

Increased birthweight is a risk factor for early neonatal complications, as well as cardiovascular and metabolic disease later in adulthood. We aimed to assess birthweight trends and the rate of large for gestational age newborns in women in their third delivery according to birthweight in the first and second deliveries.

Study design

A retrospective cohort study of all women who delivered their first three consecutive deliveries in a single medical center (1994–2013). Only non-diabetic women with term (≥ 37 weeks) singleton deliveries in all three deliveries were included. BW centile (according to local gender- and gestational age-specific birth curves) trends between deliveries was assessed. In addition, the risk for large for gestational age (≥ 90th centile) infants in the third delivery was assessed according to the presence or absence of large for gestational age in previous deliveries. Pregnancies complicated by multiple gestations, preeclampsia, chronic or gestational hypertension or fetal anomalies were excluded.

Results

Of the 121,728 deliveries during the study period, 3521 women (10,563 deliveries [8.6%]) met inclusion criteria. Mean birthweight centile in the first, second and third deliveries were 47.2 ± 26.3, 58.3 ± 25.8 and 61.5 ± 24.7, respectively (p < 0.001). While 45.9% women had their maximal birthweight centile in the third delivery, only 16.5% had it in the first delivery (p < 0.001). In multivariate analysis, adjusted for maternal age, gestational age at delivery and neonatal gender, the rate of large for gestational age infants in the third delivery was increased as the number of previous large for gestational age deliveries increased in a dose-dependent pattern (aOR = 4.37, CI  2.89–6.61 for women with large for gestational age infant only in the first delivery, aOR = 5.31, CI   4.15–6.79 for women with large for gestational age infants only in the second delivery, aOR = 10.62, CI  6.89–16.38 for women with large for gestational infants age in the first and second deliveries; women with no large for gestational age infants in both the first and second delivery served as reference group).

Conclusion

In women with repeated term deliveries, birthweight centile is frequently increased in the third delivery compared to the previous two deliveries. Moreover, the number and order of previous large for gestational age deliveries in the first two deliveries are major risk factors for large for gestational age in the third delivery.

Keywords

Large for gestational age Birthweight Term deliveries Recurrence 

Notes

Author contributions

LH: involved in the study design, researched data, wrote the manuscript and reviewed/edited the manuscript. SS: reviewed and edited the manuscript. NM: involved in the study design and reviewed/edited the manuscript. AA: reviewed and edited the manuscript. EH: involved in the study design and reviewed/edited the manuscript. YY: involved in the study design and reviewed/edited the manuscript. EA: involved in the conception of the study, writing of the protocol, data extraction, data analysis and reviewed/edited the manuscript.

Funding

None.

Compliance with ethical standards

Conflict of interest statement

ALL authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyHelen Schneider Hospital for Women, Rabin Medical CenterPetah TiqwaIsrael
  2. 2.Lis Maternity Hospital, Tel Aviv Sourasky Medical CenterTel Aviv UniversityTel AvivIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada

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