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Risk factors for recurrent macrosomia and child outcomes

  • Fang Fang
  • Qing-Ying Zhang
  • Jun Zhang
  • Xiao-Ping Lei
  • Zhong-Cheng Luo
  • Hai-Dong ChengEmail author
Original Article
  • 20 Downloads

Abstract

Background

Women who had delivered a macrosomic newborn will have a higher risk to deliver another macrosomia. We aimed to examine the recurrence risk of macrosomia in the subsequent pregnancy and the implications in long-term child health.

Methods

Data from the Collaborative Perinatal Project, a longitudinal birth cohort with 54,371 singleton births, were used. 401 recurrent macrosomic infants (macro-macro) and 1327 normal weight babies with a macrosomia in the last pregnancy (macro-normal) were selected to explore risk factors for recurrent macrosomia. Furthermore, 768 newly onset macrosomia with normal birthweight infant in previous pregnancies (normal-macro) were identified to examine long-term health effects of recurrent macrosomia.

Results

The recurrent rate of macrosomia was 23.2% [95% confidence interval (CI) 21.2%, 25.2%]. White race, higher pre-pregnant body mass index (BMI), more gestational weight gain, male infant and more prior macrosomic infants were significant risk factors for recurrent macrosomia. At 4 years of age, recurrent macrosomic infants had a higher BMI (16.7 vs. 16.1 kg/m2, adjusted β: 0.36, 95% CI: 0.12, 0.60) and a higher risk of overweight and obesity (adjusted OR: 1.56, 95% CI: 1.10, 2.23) than infants with normal birthweight after a previous macrosomic sibling. There was no significant difference between recurrent macrosomia and newly onset macrosomia in child outcomes after adjustment for covariates.

Conclusions

Fetal macrosomia has a high recurrence rate in the following pregnancy. Higher maternal pre-pregnant BMI and gestational weight gain are still important risk factors for recurrence of macrosomia, which in turn increases the risk for childhood obesity.

Keywords

Childhood Fetal macrosomia Obesity Recurrence Risk factor 

Notes

Author contributions

JZ and HDC conceived the research. FF analyzed data and drafted the manuscript. All authors were involved in revising the paper critically and approved the final version of the manuscript.

Funding

None.

Compliance with ethical standards

Ethical approval

Anonymized data were used for this study, rendering an ethical approval unnecessary by the Institutional Review Board of Xinhua Hospital.

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

12519_2019_249_MOESM1_ESM.doc (68 kb)
Supplementary material 1 (DOC 69 kb)

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Copyright information

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

Authors and Affiliations

  • Fang Fang
    • 1
    • 2
  • Qing-Ying Zhang
    • 3
  • Jun Zhang
    • 2
  • Xiao-Ping Lei
    • 4
  • Zhong-Cheng Luo
    • 2
  • Hai-Dong Cheng
    • 3
    Email author
  1. 1.Department of Developmental and Behavioral Pediatrics and Child Primary Care, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
  2. 2.Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
  3. 3.Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseaseObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
  4. 4.Department of NeonatologyThe First Affiliated Hospital of Sichuan Medical UniversityLuzhouChina

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