TY - JOUR
T1 - Risk factors for macrosomia and its clinical consequences
T2 - A study of 350,311 pregnancies
AU - Jolly, Matthew C.
AU - Sebire, Neil J.
AU - Harris, John P.
AU - Regan, Lesley
AU - Robinson, Stephen
PY - 2003/11/10
Y1 - 2003/11/10
N2 - Objectives: To identify demographic risk factors for either birthweight >4kg or over the 90th centile and to quantify the obstetric risks. Study design: Data from 350,311 completed singleton pregnancies in the North West Thames Region between 1988 and 1997 were analysed using logistic regression. Predisposing factors and pregnancy outcome were compared by birthweight 2.5-4kg (n=259,902) and >4kg (n=36,462) and 10th-90th centile (n=279,780) and >90th centile (n=34,937). Results: Macrosomia defined as birthweight >90th centile was more likely in women whose BMI >30 (kg/m 2 ) (odds ratio (OR) 2.08; confidence intervals (CI) 1.99, 2.17), parity >4 (OR 2.20; CI 2.02, 2.40), age >40 (OR 1.22; CI 1.11, 1.35) and in women with pre-existing diabetes (OR 6.97; CI 5.36, 8.16) or who developed gestational diabetes (OR 2.77; CI 2.51, 3.07). Macrosomia defined by birthweight >4kg was better than birthweight >90th centile at predicting morbidity and was associated with a prolonged first and second stage of labour (OR 1.57; CI 1.51, 1.63) and (OR 2.03; CI 1.88, 2.19), respectively, an increased risk of instrumental vaginal delivery (OR 1.76; CI 1.68, 1.85), third degree perineal trauma (OR 2.73; CI 2.30, 3.23), emergency caesarean section (OR 1.84; CI 1.75, 1.93), postpartum haemorrhage (OR 2.01; CI 1.93, 2.10), Apgar score <4 (OR 1.35; CI 1.03, 1.76), and admission to the special care baby unit (OR 1.51; CI 21.38, 1.68). Conclusion: Macrosomia is more common in mothers who are obese, older or diabetic and is associated with significant obstetric morbidity.
AB - Objectives: To identify demographic risk factors for either birthweight >4kg or over the 90th centile and to quantify the obstetric risks. Study design: Data from 350,311 completed singleton pregnancies in the North West Thames Region between 1988 and 1997 were analysed using logistic regression. Predisposing factors and pregnancy outcome were compared by birthweight 2.5-4kg (n=259,902) and >4kg (n=36,462) and 10th-90th centile (n=279,780) and >90th centile (n=34,937). Results: Macrosomia defined as birthweight >90th centile was more likely in women whose BMI >30 (kg/m 2 ) (odds ratio (OR) 2.08; confidence intervals (CI) 1.99, 2.17), parity >4 (OR 2.20; CI 2.02, 2.40), age >40 (OR 1.22; CI 1.11, 1.35) and in women with pre-existing diabetes (OR 6.97; CI 5.36, 8.16) or who developed gestational diabetes (OR 2.77; CI 2.51, 3.07). Macrosomia defined by birthweight >4kg was better than birthweight >90th centile at predicting morbidity and was associated with a prolonged first and second stage of labour (OR 1.57; CI 1.51, 1.63) and (OR 2.03; CI 1.88, 2.19), respectively, an increased risk of instrumental vaginal delivery (OR 1.76; CI 1.68, 1.85), third degree perineal trauma (OR 2.73; CI 2.30, 3.23), emergency caesarean section (OR 1.84; CI 1.75, 1.93), postpartum haemorrhage (OR 2.01; CI 1.93, 2.10), Apgar score <4 (OR 1.35; CI 1.03, 1.76), and admission to the special care baby unit (OR 1.51; CI 21.38, 1.68). Conclusion: Macrosomia is more common in mothers who are obese, older or diabetic and is associated with significant obstetric morbidity.
KW - Birthweight
KW - Macrosomia
KW - Obstetric
KW - Outcome
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=0141992765&partnerID=8YFLogxK
U2 - 10.1016/S0301-2115(03)00154-4
DO - 10.1016/S0301-2115(03)00154-4
M3 - Article
C2 - 14557004
AN - SCOPUS:0141992765
SN - 0301-2115
VL - 111
SP - 9
EP - 14
JO - European Journal of Obstetrics and Gynecology and Reproductive Biology
JF - European Journal of Obstetrics and Gynecology and Reproductive Biology
IS - 1
ER -
