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Association between fetal macrosomia and risk of obesity in children under 3 years in Western China: a cohort study

  • Xiong-Fei Pan
  • Li Tang
  • Andy H. Lee
  • Colin Binns
  • Chun-Xia Yang
  • Zhu-Ping Xu
  • Jian-Li Zhang
  • Yong Yang
  • Hong Wang
  • Xin Sun
Original Article
  • 13 Downloads

Abstract

Background

Fetal macrosomia, defined as birth weight equal or over 4000 g, is a major concern for both neonatal and maternal health. A rapid increasing trend in fetal macrosomia is observed in different regions of China. We aimed to examine the association between fetal macrosomia and risk of childhood obesity in Western China.

Methods

All macrosomic live singletons (≥ 4000 g), and a random sample of singletons with normal birth weight (2500–3999 g) born in four districts of Chengdu, Western China, in 2011 were included in the cohort study. Maternal demographics, obstetric factors, labor and delivery summary at baseline were extracted from the Chengdu Maternal and Child Health Management System. Anthropometric measurements before 3 years and infant feeding information at around 6 months were also collected. Childhood obesity under 3 years was primarily defined as a weight-for-length/height z score ≥ 1.645 using the WHO growth reference. Secondary definitions were based on weight-for-age and body mass index (BMI)-for-age over the same cut-offs.

Results

A total of 1767 infants were included in the analyses, of whom 714 were macrosomic. After controlling for maternal age, parity, gestational age and anemia at the first antenatal visit, pre-pregnancy BMI, gestational weight gain, gestational age at birth, baby age and sex, and breastfeeding practices at 6 months, the risk of childhood obesity defined according to weight-for-length/height among macrosomic babies was 1.90 (95% confidence interval 1.04–3.49) times that of babies with normal birth weight. The risk of childhood obesity for macrosomic babies was 3.74 (1.96–7.14) and 1.64 (0.89–3.00) times higher based on weight-for-age and BMI-for-age, respectively.

Conclusion

Fetal macrosomia is associated with increased risk of obesity in children under 3 years in Western China.

Keywords

Birth weight Child growth China Fetal macrosomia Obesity 

Notes

Acknowledgements

We thank relevant staff at four maternal and child health hospitals, who managed the district data for the Chengdu Maternal and Child Health Management System. Part of the work was presented at the 48th Asia–Pacific Academic Consortium for Public Health Conference (10-2-O) in Tokyo on September 18, 2016.

Author contributions

XFP and LT contributed equally to the article. XFP, LT, AHL, CB, CXY, and XS conceived the study. ZX, JZ, YY, and HW originally supervised data collection. XFP, LT, and XS conducted data analysis, interpretation, and presentation, and prepared the manuscript draft. All authors have contributed to, seen, and approved the manuscript.

Funding

The study was supported by the China Medical Board Open Competition fund (no. 14-199).

Compliance with ethical standards

Ethical approval

The study was approved by the Ethics Committee of Sichuan University Fourth Hospital/West China School of Public Health.

Conflict of interest

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

References

  1. 1.
    Kamana KC, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab. 2015;66(Suppl. 2):14–20.Google Scholar
  2. 2.
    Yin S. Nutrition status and health of children under 6 years in China: the Chinese National Nutrition and Health survey in 2002. Beijing: People’s Medical Publishing House; 2008.Google Scholar
  3. 3.
    Yu DM, Zhai FY, Zhao LY, Liu AD, Yu WT, Jia FM, et al. Incidence of fetal macrosomia and influencing factors in China in 2006 (In Chinese). Chin J Child Health Care. 2008;16:11–3 (in Chinese).Google Scholar
  4. 4.
    Li G, Kong L, Li Z, Zhang L, Fan L, Zou L, et al. Prevalence of macrosomia and its risk factors in china: a multicentre survey based on birth data involving 101,723 singleton term infants. Paediatr Perinat Epidemiol. 2014;28:345–50.CrossRefGoogle Scholar
  5. 5.
    Wang D, Hong Y, Zhu L, Wang X, Lv Q, Zhou Q, et al. Risk factors and outcomes of macrosomia in China: a multicentric survey based on birth data. J Matern Fetal Neonatal Med. 2017;30:623–7.CrossRefGoogle Scholar
  6. 6.
    Rugholm S, Baker JL, Olsen LW, Schack-Nielsen L, Bua J, Sorensen TIA. Stability of the association between birth weight and childhood overweight during the development of the obesity epidemic. Obes Res. 2005;13:2187–94.CrossRefGoogle Scholar
  7. 7.
    Yu ZB, Han SP, Zhu GZ, Zhu C, Wang XJ, Cao XG, et al. Birth weight and subsequent risk of obesity: a systematic review and meta-analysis. Obes Rev. 2011;12:525–42.CrossRefGoogle Scholar
  8. 8.
    Tanaka T, Matsuzaki A, Kuromaru R, Kinukawa N, Nose Y, Matsumoto T, et al. Association between birthweight and body mass index at 3 years of age. Pediatr Int. 2001;43:641–6.CrossRefGoogle Scholar
  9. 9.
    Takahashi E, Yoshida K, Sugimori H, Miyakawa M, Izuno T, Yamagami T, et al. Influence factors on the development of obesity in 3-year-old children based on the Toyama study. Prev Med. 1999;28:293–6.CrossRefGoogle Scholar
  10. 10.
    Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. 2004;114:e29–36.CrossRefGoogle Scholar
  11. 11.
    Li N, Liu E, Sun S, Guo J, Pan L, Wang P, et al. Birth weight and overweight or obesity risk in children under 3 years in China. Am J Hum Biol. 2014;26:331–6.CrossRefGoogle Scholar
  12. 12.
    Yu Z, Sun JQ, Haas JD, Gu Y, Li Z, Lin X. Macrosomia is associated with high weight-for-height in children aged 1–3 years in Shanghai. China. Int J Obes (Lond). 2008;32:55–60.CrossRefGoogle Scholar
  13. 13.
    He Q, Ding ZY, Fong DY, Karlberg J. Risk factors of obesity in preschool children in China: a population-based case–control study. Int J Obes Relat Metab Disord. 2000;24:1528–36.CrossRefGoogle Scholar
  14. 14.
    Zong XN, Li H. Secular trends in prevalence and risk factors of obesity in infants and preschool children in 9 Chinese cities, 1986–2006. PLoS One. 2012;7:e46942.CrossRefGoogle Scholar
  15. 15.
    Redfern KM, Rees GA, Pinkney JH. Maternal lifestyle factors and fetal macrosomia risk: a review. EMJ Reprod Health. 2016;2:52–8.Google Scholar
  16. 16.
    Chengdu Bureau of Statistics. Chengdu Statistics Book 2012, Chengdu: Chengdu Bureau of Statistics; 2013. http://www.chdstats.gov.cn/htm/list_02010912.html. Accessed 31 May 2018.
  17. 17.
    He M. Role of Chengdu maternal and child health management system in management of children at high risk (In Chinese). Front Med. 2014;2:82–3.Google Scholar
  18. 18.
    WHO Multicentre Growth Reference Study Group. WHO child growth standards based on length/height, weight and age. Acta Paediatr Suppl. 2006;450:76–85.Google Scholar
  19. 19.
    de Onis M, Lobstein T. Defining obesity risk status in the general childhood population: which cut-offs should we use? Int J Pediatr Obes. 2010;5:458–60.CrossRefGoogle Scholar
  20. 20.
    Institute of Medicine and National Research Council. Weight gain during pregnancy: reexaming the guidelines. Washington, DC: National Academies Press (US); 2009.Google Scholar
  21. 21.
    Chen C, Lu FC, Department of Disease Control Ministry of Health. The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci. 2003;17:1–36.Google Scholar
  22. 22.
    Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth. 2010;10:S1.CrossRefGoogle Scholar
  23. 23.
    Spong CY. Defining “term” pregnancy: recommendations from the Defining “Term” Pregnancy Workgroup. JAMA. 2013;309:2445–6.CrossRefGoogle Scholar
  24. 24.
    American College of Obstetricians and Gynecologists. ACOG Committee Opinion No 579: definition of term pregnancy. Obstet Gynecol. 2013;122:1139–40.CrossRefGoogle Scholar
  25. 25.
    Chagnon YC, Rankinen T, Snyder EE, Weisnagel SJ, Pérusse L, Bouchard C. The human obesity gene map: the 2002 update. Obes Rev. 2003;11:313–67.CrossRefGoogle Scholar
  26. 26.
    Rhee KE, Phelan S, McCaffery J. Early determinants of obesity: genetic, epigenetic, and in utero influences. Int J Pediatr. 2012;2012:463850.CrossRefGoogle Scholar
  27. 27.
    Cleary-Goldman J, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, et al. Impact of maternal age on obstetric outcome. Obstet Gynecol. 2005;105:983–90.CrossRefGoogle Scholar
  28. 28.
    Chatfield J. ACOG issues guidelines on fetal macrosomia. Am Fam Physician. 2001;64:169–70.PubMedGoogle Scholar
  29. 29.
    Langer O. Fetal macrosomia: etiologic factors. Clin Obstet Gynecol. 2000;43:283–97.CrossRefGoogle Scholar
  30. 30.
    Bouchard C. Childhood obesity: are genetic differences involved? Am J Clin Nutr. 2009;89:1494S–501S.CrossRefGoogle Scholar
  31. 31.
    Ren J, Wu J, Ji M, Rong F, Li Y, Gao E, et al. The effect of high birth weight on overweight and obesity in childhood and adolescence. A cohort study in China. Saudi Med J. 2013;34:623–31.PubMedGoogle Scholar
  32. 32.
    Armitage JA, Poston L, Taylor PD. Developmental origins of obesity and the metabolic syndrome: the role of maternal obesity. Front Horm Res. 2008;36:73–84.CrossRefGoogle Scholar
  33. 33.
    Simmonds M, Llewellyn A, Owen CG, Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev. 2015;17:95–107.CrossRefGoogle Scholar
  34. 34.
    NCD Risk Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2016;387:1377–96.CrossRefGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2019

Authors and Affiliations

  • Xiong-Fei Pan
    • 1
    • 2
  • Li Tang
    • 3
  • Andy H. Lee
    • 4
  • Colin Binns
    • 4
  • Chun-Xia Yang
    • 5
  • Zhu-Ping Xu
    • 6
  • Jian-Li Zhang
    • 7
  • Yong Yang
    • 8
  • Hong Wang
    • 9
  • Xin Sun
    • 1
  1. 1.Chinese Evidence-based Medicine Center, Center for Clinical Epidemiology and Evidence-based MedicineWest China Hospital, Sichuan UniversityChengduChina
  2. 2.Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  3. 3.Department of Research and EducationSichuan Jinxin Women’s and Children’s HospitalChengduChina
  4. 4.Department of Epidemiology and Biostatistics, School of Public HealthCurtin UniversityPerthAustralia
  5. 5.Department of Epidemiology and Biostatistics, West China School of Public HealthSichuan UniversityChengduChina
  6. 6.Shuangliu Maternal and Child Health HospitalChengduChina
  7. 7.Wenjiang Maternal and Child Health HospitalChengduChina
  8. 8.Longquan Maternal and Child Health HospitalChengduChina
  9. 9.Pidu Maternal and Child Health HospitalChengduChina

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