Abstract
ABSTRACTOBJECTIVE To evaluate the clinical factors, as well as weight gain, in a group of pregnant women, associating them with fetal macrosomia in a public institution in Antioquia, Colombia, from 2010-2017.METHODS A case-control study, using secondary information registries. Cases were defined using newborn weight of ≥ 4000g, while controls were defined as newborn weight between 3000–3999g. A proportion ratio (PR) was established to evaluate factors associated with macrosomia, and a generalized linear model (GLM) of Poisson regression with robust variance was used to evaluate the aspects that best explained macrosomia in the neonate.RESULTS 122 pregnant women participated in the study, of which 611 were cases and 61 were controls. Of the participants, 44.3% had pre-pregnancy overweight and 48.4% had excess gestational weight gain. Statistically significant differences were found between the groups in the following variables: pre-pregnancy BMI (p = 0.004), gestational weight gain (p = 0.000), gestational diabetes (p = 0.000), and type of delivery (p = 0.004). According to the regression model, a macrosomic newborn is 3.5 times more likely in women with excessive gestational weight gain (95%CI 1.78-7.18) and twice more likely in women who have gestational diabetes (95%CI 1.51-2.76). Of women with pre-pregnancy excess weight, 63% had excess gestational weight gain.CONCLUSIONS Within this cohort, pre-pregnancy BMI, excess weight gain in pregnancy, and the presence of gestational diabetes were associated with an increased risk of neonatal macrosomia. pre-pregnancy BMI and weight gain in pregnancy are modifiable risk factors that are responsive to nutrition interventions, which can minimize adverse perinatal outcomes.
Highlights
Significant differences were found between the groups in the following variables: pre-pregnancy body mass index (BMI) (p = 0.004), gestational weight gain (p = 0.000), gestational diabetes (p = 0.000), and type of delivery (p = 0.004)
Of women with pre-pregnancy excess weight, 63% had excess gestational weight gain. Within this cohort, pre-pregnancy BMI, excess weight gain in pregnancy, and the presence of gestational diabetes were associated with an increased risk of neonatal macrosomia. pre-pregnancy BMI and weight gain in pregnancy are modifiable risk factors that are responsive to nutrition interventions, which can minimize adverse perinatal outcomes
Almost half of the pregnant women were overweight or obesity before pregnancy. This is in line with results of the 2015 National Survey of Nutrition Situation in Colombia[3], which found that 39.9% of them presented excess weight
Summary
Report of the Panorama of Food and Nutrition Security in Latin America and the Caribbean has shown that overweight and obesity, in more than 20 countries on the continent, was 10 percentage points higher in women than in men in 20161. A report prepared in 2015 by the United Nations states that one in four women in adulthood is obese[2]. The situation is no different in Colombia: the prevalence of overweight and obesity in the adult population is 55.2% in women compared with 45.6% in men[3]. The 2015 National Survey of Nutrition Situation in Colombia indicates that 39.9% of pregnant women of all age groups were overweight (24.7% overweight and 15.2% obese) in the country[3]. Other observational studies in representative samples of pregnant women in countries such as Peru[4], Brazil[5], and Uruguay[6] show overweight prevalence of 63.8%, 47.5% and 32.6%, respectively
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