Occurrence and Influencing Factors of Macrosomia

Abstract

Objective To investigate the risk factors of gestational women who delivered macrosomia. Methods Clinical data of 7805 pregnant women(singleton pregnancy)who had antenatal care and delivered in Capital Medical University Affixed Beijing Obstetrics and Gynecology Hospital from January to December 2010 were retrospectively analyzed. According to birthweight of neonats, they were divided into macrosomia group (n=593, birthweight≥4000 g) and normal neonate weight group(n=7212, 4000 g>birthweight≥2500 g). All the indicators relevant to macrosomia were analyzed, such as body mass index(BMI), oral glucose tolerance test(OGTT), common situation, gestational weight, blood glucose and delivery situation. They were firstly analyzed by univariate analysis method. Then the meaningful indicators were analyzed by non-conditional multivariate logistic regression method.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Capital Medical University Affixed Beijing Obstetrics and Gynecology Hospital. Informed consent was obtained from the parents of each participating neonate. Results ①There had significance difference between two groups among ages, parities, gestational age at time to begin antenatal examination and asphyxia rate of neonates(P>0.05). ②There had significance difference between two groups among gravidities, pre-pregnancy weight, pre-pregnancy BMI, prenatal weight, prenatal BMI, gestational weight gain, fasting plasma glucose, levels of OGTT 1 h, 2 h, gestational age, modes of delivery, gestational age at delivery, and birth weight, sex of neonates(P<0.05). ③Analyzed by non-conditional multivariate logistic regression showed those high risk factors for macrosomia were gestational age≥40 weeks, BMI≥28 kg/cm2 at delivery, the number of pregnancies reaching 6, cesarean section, fasting plasma glucose≥5.1 mmol/L, male fetus and blood glucose levels of OGTT 2 h≥8.5 mmol/L. Conclusions To control levels of fasting plasma glucose and levels of postprandial blood glucose, keep the gestational weight in appropriate ranges, decrease the prenatal BMI and terminate pregnancy timely can reduce incidence of macrosomia. Key words: macrosomia; influencing factor; blood glucose; gestational weight; number of pregnancy