Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland.
Department of Sociology, Institute of Philosophy and Sociology Polish Academy of Sciences, Warsaw, Poland.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):5564-5571. doi: 10.1080/14767058.2021.1887127. Epub 2021 Feb 18.
Small for gestational age (SGA) fetuses and neonates are of great interest, while those who are too big are much less studied. The aim was to analyze the classifiers described by ACOG "Fetal macrosomia" practice bulletin as predictors of adverse perinatal outcomes for overgrown fetuses and their mothers.
From a database of 53,586 singleton term births, appropriate-for-gestational-age (AGA), large for gestational age (LGA), and macrosomic deliveries were selected. AGA served as a control. The crude and adjusted odds ratios (aORs) were calculated for large-for-gestational-age >90th centile, and macrosomia >4000 g, >4250 g, and >4500 g. Patients with and without diabetes were analyzed separately
Macrosomia >4000 g performed poorer than other classifiers. LGA performed comparably to other definitions of macrosomia. Diabetes carries a severe risk of complications for overgrown neonates, but those non-diabetic also have increased risk.
Definition of macrosomia as weight >4000 g should be reconsidered. LGA >90th centile should be used as a definition of fetal overgrowth along with other definitions of macrosomia.
小于胎龄儿（SGA）胎儿和新生儿备受关注，而过大儿则研究较少。本研究旨在分析 ACOG“胎儿巨大儿”实践公告中描述的分类器，作为预测过大胎儿及其母亲不良围产结局的指标。
从 53586 例单胎足月分娩的数据库中，选择了适于胎龄儿（AGA）、大于胎龄儿（LGA）和巨大儿分娩。AGA 作为对照。计算了大于胎龄儿>第 90 百分位数和巨大儿>4000g、>4250g 和>4500g 的粗比值比（ORs）和调整比值比（aORs）。分别分析了有和没有糖尿病的患者。
巨大儿>4000g 的表现不如其他分类器。LGA 与其他巨大儿定义的表现相当。糖尿病使巨大儿发生并发症的风险严重增加，但非糖尿病患者的风险也增加。
应重新考虑将体重>4000g 定义为巨大儿。LGA>第 90 百分位数应与其他巨大儿定义一起用作胎儿过度生长的定义。
