Chen Yu-Hsuan, Chen Wei-Yu, Chang Chia-Yuan, Cho Ching-Yi, Tang Yi-Hsuan, Yeh Chang-Ching, Yang Yi-Hsin, Tsao Pei-Chen, Lee Yu-Sheng
Department of Pediatrics, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Pediatrics, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2023 Mar 1;86(3):324-329. doi: 10.1097/JCMA.0000000000000871. Epub 2023 Jan 9.
Macrosomia, defined as a birth weight of ≥4000 g, is associated with a high risk of birth injury. Fetal growth is highly correlated with maternal conditions, and several maternal factors are associated with neonatal birth size. The current study aimed to assess maternal factors related to fetal macrosomia in a Taiwanese population.
The medical records of pregnant mothers and their newborns were retrospectively reviewed. All singleton pregnancies delivered at and after 37 weeks of gestation were included in the analysis. Maternal and neonatal conditions were evaluated according to different birth weights.
A total of 4262 infants were enrolled in our study. The mean birth weight was 3156 ± 383 g, including 77 (1.8%) cases with birth weight ≥4000 g, and 154 (3.6%) infants with birth weight <2500 g. The mean maternal body weight before delivery was 67.6 ± 10.0 kg. The mean 6-month gestational weight gain (6mGWG) was 12.3 ± 4.2 kg, and the mean maternal body mass index (BMI) was 26.2 ± 3.6 kg/m 2 . The maternal weight, height, and 6mGWG, gestational age, and placental weight were significantly positively correlated with neonatal birth weight. The odds ratios of macrosomia were 3.1 in neonates born to mothers with a 6mGWG of ≥15 kg, 6.3 in those born to mothers with gestational diabetes mellitus, and 4.1 in those born to mothers with a BMI of ≥30 kg/m 2 . Newborn macrosomia was associated with adverse events in pregnant mothers and newborn infants.
Gestational diabetes mellitus, 6mGWG, and maternal BMI are significantly correlated with neonatal macrosomia in full-term singleton births. Further, neonatal macrosomia is an important cause of maternal and neonatal morbidity. Hence, pregnant women should undergo maternal counseling for weight management before and during pregnancy, and the appropriate delivery method should be identified to prevent perinatal adverse events.
巨大儿定义为出生体重≥4000克,与高出生损伤风险相关。胎儿生长与母亲状况高度相关,多种母亲因素与新生儿出生大小有关。本研究旨在评估台湾人群中与胎儿巨大儿相关的母亲因素。
回顾性分析孕妇及其新生儿的病历。分析纳入所有孕37周及以后分娩的单胎妊娠。根据不同出生体重评估母亲和新生儿状况。
本研究共纳入4262例婴儿。平均出生体重为3156±383克,其中出生体重≥4000克的有77例(1.8%),出生体重<2500克的婴儿有154例(3.6%)。分娩前母亲平均体重为67.6±10.0千克。妊娠6个月体重增加(6mGWG)平均为12.3±4.2千克,母亲平均体重指数(BMI)为26.2±3.6千克/平方米。母亲体重、身高、6mGWG、孕周和胎盘重量与新生儿出生体重显著正相关。6mGWG≥15千克的母亲所生新生儿巨大儿的比值比为3.1,患有妊娠期糖尿病的母亲所生新生儿为6.3,BMI≥30千克/平方米的母亲所生新生儿为4.1。新生儿巨大儿与母亲和新生儿的不良事件相关。
妊娠期糖尿病、6mGWG和母亲BMI与足月单胎分娩的新生儿巨大儿显著相关。此外,新生儿巨大儿是母亲和新生儿发病的重要原因。因此,孕妇在孕前和孕期应接受体重管理的咨询,并确定合适的分娩方式以预防围产期不良事件。