Epidemiology and Risk Factors of Macrosomia

Background: The incidence of macrosomia is rising worldwide. This study aimed to investigate the epidemiological characteristics and risk factors of macrosomia in a specific region of China. In addition, we evaluated the impact of gestational diabetes mellitus (GDM) interventions among outpatients. Methods: This retrospective study included 6803 singleton term live births at People’s Hospital of Fuyang from July 1, 2023 to June 30, 2024. Participants were categorized into a macrosomia group and a non-macrosomia group. GDM cases, were further divided into an intervention group, which received outpatient GDM management and a control group (standard care). Key indicators included macrosomia-related measures (neonatal birth weight and maternal and fetal parameters), GDM related measures and epidemiological indices. The statistical methods we employed include the Mann-Whitney U Test, the χ2 test or Fisher’s exact test, as appropriate. Logistic regression (univariate and multivariate) was utilized to calculate the odds ratio and confidence interval for macrosomia risk. Receiver operating characteristic (ROC) analysis, using Youden’s index and 70%/30% training/validation split was used to determine the optimal cut-off values. Results: The incidence of macrosomia in this hospital was 7.29% (496/6803), while the incidence of GDM was 7.11% (484/6803). Except for maternal age, all other demographic characteristics were significantly higher in the macrosomia group compared to the non-macrosomia group, including pre-pregnancy weight, pre-delivery weight, and abdominal circumference (AC) (p 1). Intervention through a GDM outpatient clinic resulted in significantly lower pre-delivery weight and reduced weight gain during pregnancy compared to the control group (p < 0.05). Following adjustment for confounding factors, multivariate analysis found that structured intervention in the GDM outpatient clinic significantly reduced the risk of macrosomia (p = 0.002). Conclusions: Pregnant women in this region of China exhibit a high incidence of overweight and macrosomia. Pre-pregnancy weight, pre-delivery weight, pre-pregnancy BMI, and weight gain during pregnancy identified as independent risk factors for macrosomia. Each of these factors can be controlled. Intervention through GDM outpatient clinics can promote healthier eating habits and significantly reduce the incidence of macrosomia, weight gain during pregnancy, and the excessive weight gain during pregnancy.