Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies
Objectives: To identify demographic risk factors for either birthweight >4 kg 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...
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| Veröffentlicht in: | European journal of obstetrics & gynecology and reproductive biology 2003-11, Vol.111 (1), p.9-14 |
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| creator | Jolly, Matthew C. Sebire, Neil J. Harris, John P. Regan, Lesley Robinson, Stephen |
| description | Objectives: To identify demographic risk factors for either birthweight >4
kg 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 2.5–4
kg (
n=259,902) and >4
kg (
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 >4
kg 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 |
| doi_str_mv | 10.1016/S0301-2115(03)00154-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71290519</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0301211503001544</els_id><sourcerecordid>71290519</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-c87cd75af4af314c20a286d9eee3d95211eed0ff4a8c81eaf9e55ad47441d6763</originalsourceid><addsrcrecordid>eNqFkE1v1DAQhq0K1G5LfwLIF1CRCHhiO064IFTxJVWqBPTQk-XaY2RI4q0nW6n_Hm93RY_4Mgc_M_POw9hzEG9BQPfuh5ACmhZAnwn5WgjQqlEHbAW9aRvTafWErf4hR-yY6LeoT8rhkB2B0toIoVbs-nuiPzw6v-RCPObCJ-dLpjwlx90ceFqI-zHNybuR-zwT3m5w9kjvueO0bMI9z5FLLd5IAL4u-Gt2s09Iz9jT6EbC0309YVefP_08_9pcXH75dv7xovFKm6XxvfHBaBeVixKUb4Vr-y4MiCjDoGt6xCBi_e59D-jigFq7oIxSEDrTyRP2ajd3XXKNRoudEnkcRzdj3pA10A5Cw1BBvQO391HBaNclTa7cWxB269Q-OLVbYVZI--DUqtr3Yr9gczNheOzaS6zAyz3gqFqKZSuAHrm6vO1UW7kPOw6rjruExVIVVV2GVNAvNuT0nyh_AcUgkl0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71290519</pqid></control><display><type>article</type><title>Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Jolly, Matthew C. ; Sebire, Neil J. ; Harris, John P. ; Regan, Lesley ; Robinson, Stephen</creator><creatorcontrib>Jolly, Matthew C. ; Sebire, Neil J. ; Harris, John P. ; Regan, Lesley ; Robinson, Stephen</creatorcontrib><description>Objectives: To identify demographic risk factors for either birthweight >4
kg 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 2.5–4
kg (
n=259,902) and >4
kg (
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 >4
kg 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.</description><identifier>ISSN: 0301-2115</identifier><identifier>EISSN: 1872-7654</identifier><identifier>DOI: 10.1016/S0301-2115(03)00154-4</identifier><identifier>PMID: 14557004</identifier><identifier>CODEN: EOGRAL</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Birthweight ; Delivery, Obstetric - statistics & numerical data ; Diabetes, Gestational - complications ; Diabetes, Gestational - epidemiology ; Diseases of mother, fetus and pregnancy ; England - epidemiology ; Female ; Fetal Macrosomia - epidemiology ; Fetal Macrosomia - etiology ; Gynecology. Andrology. Obstetrics ; Humans ; Macrosomia ; Maternal Age ; Medical sciences ; Obstetric ; Outcome ; Postpartum Hemorrhage - epidemiology ; Postpartum Hemorrhage - etiology ; Pregnancy ; Pregnancy in Diabetics - complications ; Pregnancy in Diabetics - epidemiology ; Pregnancy Outcome ; Pregnancy. Fetus. Placenta ; Risk ; Risk Factors</subject><ispartof>European journal of obstetrics & gynecology and reproductive biology, 2003-11, Vol.111 (1), p.9-14</ispartof><rights>2003 Elsevier Science Ireland Ltd</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-c87cd75af4af314c20a286d9eee3d95211eed0ff4a8c81eaf9e55ad47441d6763</citedby><cites>FETCH-LOGICAL-c457t-c87cd75af4af314c20a286d9eee3d95211eed0ff4a8c81eaf9e55ad47441d6763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0301-2115(03)00154-4$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15192642$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14557004$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jolly, Matthew C.</creatorcontrib><creatorcontrib>Sebire, Neil J.</creatorcontrib><creatorcontrib>Harris, John P.</creatorcontrib><creatorcontrib>Regan, Lesley</creatorcontrib><creatorcontrib>Robinson, Stephen</creatorcontrib><title>Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies</title><title>European journal of obstetrics & gynecology and reproductive biology</title><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><description>Objectives: To identify demographic risk factors for either birthweight >4
kg 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 2.5–4
kg (
n=259,902) and >4
kg (
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 >4
kg 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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Birthweight</subject><subject>Delivery, Obstetric - statistics & numerical data</subject><subject>Diabetes, Gestational - complications</subject><subject>Diabetes, Gestational - epidemiology</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>England - epidemiology</subject><subject>Female</subject><subject>Fetal Macrosomia - epidemiology</subject><subject>Fetal Macrosomia - etiology</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Macrosomia</subject><subject>Maternal Age</subject><subject>Medical sciences</subject><subject>Obstetric</subject><subject>Outcome</subject><subject>Postpartum Hemorrhage - epidemiology</subject><subject>Postpartum Hemorrhage - etiology</subject><subject>Pregnancy</subject><subject>Pregnancy in Diabetics - complications</subject><subject>Pregnancy in Diabetics - epidemiology</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Risk</subject><subject>Risk Factors</subject><issn>0301-2115</issn><issn>1872-7654</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1v1DAQhq0K1G5LfwLIF1CRCHhiO064IFTxJVWqBPTQk-XaY2RI4q0nW6n_Hm93RY_4Mgc_M_POw9hzEG9BQPfuh5ACmhZAnwn5WgjQqlEHbAW9aRvTafWErf4hR-yY6LeoT8rhkB2B0toIoVbs-nuiPzw6v-RCPObCJ-dLpjwlx90ceFqI-zHNybuR-zwT3m5w9kjvueO0bMI9z5FLLd5IAL4u-Gt2s09Iz9jT6EbC0309YVefP_08_9pcXH75dv7xovFKm6XxvfHBaBeVixKUb4Vr-y4MiCjDoGt6xCBi_e59D-jigFq7oIxSEDrTyRP2ajd3XXKNRoudEnkcRzdj3pA10A5Cw1BBvQO391HBaNclTa7cWxB269Q-OLVbYVZI--DUqtr3Yr9gczNheOzaS6zAyz3gqFqKZSuAHrm6vO1UW7kPOw6rjruExVIVVV2GVNAvNuT0nyh_AcUgkl0</recordid><startdate>20031110</startdate><enddate>20031110</enddate><creator>Jolly, Matthew C.</creator><creator>Sebire, Neil J.</creator><creator>Harris, John P.</creator><creator>Regan, Lesley</creator><creator>Robinson, Stephen</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20031110</creationdate><title>Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies</title><author>Jolly, Matthew C. ; Sebire, Neil J. ; Harris, John P. ; Regan, Lesley ; Robinson, Stephen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-c87cd75af4af314c20a286d9eee3d95211eed0ff4a8c81eaf9e55ad47441d6763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Birthweight</topic><topic>Delivery, Obstetric - statistics & numerical data</topic><topic>Diabetes, Gestational - complications</topic><topic>Diabetes, Gestational - epidemiology</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>England - epidemiology</topic><topic>Female</topic><topic>Fetal Macrosomia - epidemiology</topic><topic>Fetal Macrosomia - etiology</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Macrosomia</topic><topic>Maternal Age</topic><topic>Medical sciences</topic><topic>Obstetric</topic><topic>Outcome</topic><topic>Postpartum Hemorrhage - epidemiology</topic><topic>Postpartum Hemorrhage - etiology</topic><topic>Pregnancy</topic><topic>Pregnancy in Diabetics - complications</topic><topic>Pregnancy in Diabetics - epidemiology</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Risk</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jolly, Matthew C.</creatorcontrib><creatorcontrib>Sebire, Neil J.</creatorcontrib><creatorcontrib>Harris, John P.</creatorcontrib><creatorcontrib>Regan, Lesley</creatorcontrib><creatorcontrib>Robinson, Stephen</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jolly, Matthew C.</au><au>Sebire, Neil J.</au><au>Harris, John P.</au><au>Regan, Lesley</au><au>Robinson, Stephen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies</atitle><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><date>2003-11-10</date><risdate>2003</risdate><volume>111</volume><issue>1</issue><spage>9</spage><epage>14</epage><pages>9-14</pages><issn>0301-2115</issn><eissn>1872-7654</eissn><coden>EOGRAL</coden><abstract>Objectives: To identify demographic risk factors for either birthweight >4
kg 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 2.5–4
kg (
n=259,902) and >4
kg (
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 >4
kg 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.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>14557004</pmid><doi>10.1016/S0301-2115(03)00154-4</doi><tpages>6</tpages></addata></record> |
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| ispartof | European journal of obstetrics & gynecology and reproductive biology, 2003-11, Vol.111 (1), p.9-14 |
| issn | 0301-2115 1872-7654 |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adolescent Adult Biological and medical sciences Birthweight Delivery, Obstetric - statistics & numerical data Diabetes, Gestational - complications Diabetes, Gestational - epidemiology Diseases of mother, fetus and pregnancy England - epidemiology Female Fetal Macrosomia - epidemiology Fetal Macrosomia - etiology Gynecology. Andrology. Obstetrics Humans Macrosomia Maternal Age Medical sciences Obstetric Outcome Postpartum Hemorrhage - epidemiology Postpartum Hemorrhage - etiology Pregnancy Pregnancy in Diabetics - complications Pregnancy in Diabetics - epidemiology Pregnancy Outcome Pregnancy. Fetus. Placenta Risk Risk Factors |
| title | Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies |
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