Xue Rui, Yun Zhongming
Department of Neonatology, Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, China.
J Int Med Res. 2025 Aug;53(8):3000605251365806. doi: 10.1177/03000605251365806. Epub 2025 Aug 13.
ObjectiveWe aimed to identify risk factors for macrosomia in women with high-risk pregnancies, which will allow for early identification and timely intervention and improve the health of mothers and infants.MethodsA retrospective case-control study was conducted of pregnant women and neonates born at Shenmu Hospital in China between 1 January 2020 and 31 December 2023. Cases comprised neonates with macrosomia (birth weight ≥4000 g), and controls comprised a group of normal-weight neonates (birth weight 2500-3999 g). Conditional logistic regression analysis was performed to identify independent predictor variables.ResultsIn total, 10,253 cases with complete maternal and neonatal-related data were included in this study, with 1100 cases in the macrosomia group and 9153 in the control group. Male neonates (odds ratio = 1.636), gestational age (odds ratio = 1.726), maternal height ≥165 cm (odds ratio = 3.648), prepregnancy body mass index ≥28 kg/m (odds ratio = 2.733), excessive weight gain during pregnancy (odds ratio = 2.817), ≥2 pregnancies (odds ratio = 1.368), ≥2 prior deliveries (odds ratio = 1.285), gestational diabetes (odds ratio = 3.227), excess amniotic fluid (odds ratio = 4.592), scarred uterus (odds ratio = 0.693), gestational hypertension (odds ratio = 0.750), oligohydramnios (odds ratio = 0.262), and umbilical cord anomalies (odds ratio = 0.727) were all associated with an increased risk of macrosomia.ConclusionsWomen with high-risk pregnancies who have a height of ≥165 cm, ≥2 previous deliveries, prepregnancy obesity, and a scarred uterus should be provided with individualized prenatal care and delivery plans; for these women, monitoring weight gain, blood glucose, and amniotic fluid should be intensified along with targeted interventions to provide optimal care for this high-risk population.
目的
我们旨在确定高危妊娠女性发生巨大儿的风险因素，以便早期识别并及时干预，从而改善母婴健康。
方法
对2020年1月1日至2023年12月31日在中国神木医院出生的孕妇及新生儿进行一项回顾性病例对照研究。病例组为巨大儿（出生体重≥4000g）新生儿，对照组为一组正常体重新生儿（出生体重2500 - 3999g）。采用条件逻辑回归分析来确定独立预测变量。
结果
本研究共纳入10253例具有完整母婴相关数据的病例，其中巨大儿组1100例，对照组9153例。男性新生儿（比值比 = 1.636）、孕周（比值比 = 1.726）、母亲身高≥165cm（比值比 = 3.648）、孕前体重指数≥28kg/m（比值比 = 2.733）、孕期体重增加过多（比值比 = 2.817）、≥2次妊娠（比值比 = 1.368）、≥2次既往分娩（比值比 = 1.285）、妊娠期糖尿病（比值比 = 3.227）、羊水过多（比值比 = 4.592）、瘢痕子宫（比值比 = 0.693）、妊娠期高血压（比值比 = 0.750）、羊水过少（比值比 = 0.262）以及脐带异常（比值比 = 0.727）均与巨大儿风险增加相关。
结论
对于身高≥165cm、既往有≥2次分娩、孕前肥胖且有瘢痕子宫的高危妊娠女性，应提供个体化的产前检查和分娩计划；对于这些女性，应加强体重增加、血糖和羊水的监测，并进行针对性干预，为这一高危人群提供最佳护理。
