Hamisu M Salihu1,2, Deepa Dongarwar3,4, Lindsey M King5,6,7, Korede K Yusuf8, Sahra Ibrahimi8, Abraham A Salinas-Miranda9. 1. Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX, 77098, USA. Hamisu.salihu@bcm.edu. 2. Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA. Hamisu.salihu@bcm.edu. 3. Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX, 77098, USA. 4. Office of the Provost, Baylor College of Medicine, Houston, TX, USA. 5. Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA. 6. Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. 7. College of Public Health, University of South Florida, Tampa, FL, USA. 8. College of Nursing and Public Health, Adelphi University, Garden City, NY, USA. 9. Center of Excellence in Maternal and Child Health Education, Science, and Practice, College of Public Health, University of South Florida, Tampa, FL, USA.
Abstract
PURPOSE: Studies have reported a surge in the prevalence of obesity among various demographic groups including pregnant women in the U.S. Given the association between maternal obesity and risk of fetal macrosomia, we hypothesized that the incidence of fetal macrosomia will be on the rise in the U.S. We examined trends in fetal macrosomia and macrosomia phenotypes in the U.S. among singleton live births within the gestational age of 28-42 weeks inclusive. METHODS: This was a retrospective cohort study covering the period 1971-2017 using U.S. Natality Data files. We applied Joinpoint regression models to derive the average annual percentage change in the outcome. We measured incidence and trends of fetal macrosomia which was defined as birth weight ≥ 4000 g. We further subdivided macrosomia into its phenotypes as previously recommended: Grade 1 (4000-4499 g), Grade 2 (4500-4999 g) and Grade 3 (≥ 5000 g). RESULTS: A total of 147,331,305 singleton births over the entire study period of 47 years were analyzed. From a baseline incidence of 8.84%, the rate of fetal macrosomia declined to 8.07% by the end of the study representing a drop of 8.70% in relative terms. The greatest drop was among infants with Grade 3 macrosomia, the most severe and lethal phenotype. The most impactful factors were maternal age and gestational weight gain. CONCLUSION: This study is the largest population-based study conducted regarding fetal macrosomia. The rate of fetal macrosomia declined over the previous 5 decades with the most substantial drop observed in the phenotype with the worst prognosis.
PURPOSE: Studies have reported a surge in the prevalence of obesity among various demographic groups including pregnant women in the U.S. Given the association between maternal obesity and risk of fetal macrosomia, we hypothesized that the incidence of fetal macrosomia will be on the rise in the U.S. We examined trends in fetal macrosomia and macrosomia phenotypes in the U.S. among singleton live births within the gestational age of 28-42 weeks inclusive. METHODS: This was a retrospective cohort study covering the period 1971-2017 using U.S. Natality Data files. We applied Joinpoint regression models to derive the average annual percentage change in the outcome. We measured incidence and trends of fetal macrosomia which was defined as birth weight ≥ 4000 g. We further subdivided macrosomia into its phenotypes as previously recommended: Grade 1 (4000-4499 g), Grade 2 (4500-4999 g) and Grade 3 (≥ 5000 g). RESULTS: A total of 147,331,305 singleton births over the entire study period of 47 years were analyzed. From a baseline incidence of 8.84%, the rate of fetal macrosomia declined to 8.07% by the end of the study representing a drop of 8.70% in relative terms. The greatest drop was among infants with Grade 3 macrosomia, the most severe and lethal phenotype. The most impactful factors were maternal age and gestational weight gain. CONCLUSION: This study is the largest population-based study conducted regarding fetal macrosomia. The rate of fetal macrosomia declined over the previous 5 decades with the most substantial drop observed in the phenotype with the worst prognosis.
Entities:
Keywords:
Macrosomia; Macrosomia in US; Pregnancy weight gain; Types of macrosomia
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