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01-12-2021 | Gestational Diabetes | Research article

Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study

Authors: Guoju Li, Yuhan Xing, Guolan Wang, Jun Zhang, Qin Wu, Wei Ni, Na Jiao, Wenjing Chen, Qing Liu, Li Gao, Zhenhong Zhang, Yao Wang, Quansheng Xing

Published in: BMC Medicine | Issue 1/2021

Abstract

Background

The differential effect of pre-pregnancy low BMI on macrosomia has not been fully addressed. Herein, we conducted a city-wide population-based cohort study to illuminate the association between pre-pregnancy low BMI and macrosomia, stratifying by maternal age, parity, and GDM status.

Methods

All pregnant women who paid their first prenatal visit to the hospital in Qingdao during August 1, 2018, to June 30, 2020, were recruited to this study. The interactive effect of maternal age and pre-pregnancy low BMI on macrosomia was evaluated using logistic regression models, followed by strata-specific analyses.

Results

A total of 105,768 mother-child pairs were included, and the proportion of fetal macrosomia was 11.66%. The interactive effect of maternal pre-pregnancy BMI and age was statistically significant on macrosomia irrespective of parity (nullipara: P_adjusted=0.0265; multipara: P_adjusted=0.0356). The protective effect of low BMI on macrosomia was most prominent among nullipara aged 35 years and above (aOR=0.16, 95% CI 0.05–0.49) and multipara aged 25 years and below (aOR=0.17, 95% CI 0.05–0.55). In nullipara without GDM, the risk estimates gradually declined with increasing conception age (20-to-24 years: aOR=0.64, 95% CI 0.51–0.80; 25-to-29 years: aOR=0.43 95% CI 0.36–0.52; 30-to-34 years: aOR=0.40 95% CI 0.29–0.53; and ≥35 years: aOR=0.19, 95% CI 0.06–0.60). A similar pattern could also be observed in nullipara with GDM, where the aOR for low BMI on macrosomia decreased from 0.54 (95% CI 0.32–0.93) in pregnant women aged 25–29 years to 0.30 (95% CI 0.12–0.75) among those aged 30–34 years. However, younger multiparous mothers, especially those aged 25 years and below without GDM (aOR=0.21, 95% CI 0.06–0.68), were more benefited from a lower BMI against the development of macrosomia.

Conclusions

Maternal low BMI is inversely associated with macrosomia irrespective of maternal age and parity. The impact of pre-pregnancy low BMI on macrosomia varied by maternal age and parity. The protective effect of a lower maternal BMI against fetal macrosomia was more prominent in nulliparous mothers aged 35 years and above, whereas multiparous mothers younger than 25 years of age were more benefited.

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Title: Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study
Authors: Guoju Li
Yuhan Xing
Guolan Wang
Jun Zhang
Qin Wu
Wei Ni
Na Jiao
Wenjing Chen
Qing Liu
Li Gao
Zhenhong Zhang
Yao Wang
Quansheng Xing
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Gestational Diabetes
Gestational Diabetes
Published in: BMC Medicine / Issue 1/2021
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/s12916-021-02046-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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