Association of maternal risk factors with large for gestational age fetuses in Indian population

Abstract

Objective: To estimate the risk of delivering large-for gestational age (LGA) fetuses associated with maternal obesity, excessive maternal weight gain, and gestational diabetes mellitus (GDM)- in Indian mothers. Design: Retrospective study. Settings: Fernandez Hospital Private Limited, Hyderabad, Andhra Pradesh, India; a tertiary perinatal centre. Populations: Pregnant singleton mothers with correct pregnancy dating. Methods: Estimated fetal weight (EFW) is determined using ultrasound variables [Biparietal diameter (BPD), Head Circumference (HC), Abdominal Circumference (AC), Femur Length (FL)]. This EFW is plotted on SONOCARE software [Medialogic solutions (P) Ltd, Chennai, India] to determine the type of antenatal fetal growth and a total of 192 LGA fetuses are selected. At birth newborn growth pattern are determined according to birth weight at the gestational age of delivery which divide the cohort into two groups: true LGA fetuses after delivery and true AGA fetuses after delivery. Main outcome measures: The association of maternal risk factors (body mass index, maternal weight gain and gestational diabetes mellitus) to the newborns between these two groups is evaluated. Results: Among the risk factors obesity and excess maternal weight gain among non-obese has highest risks for delivering LGA fetuses (relative risk 1.89 and 1.88; respectively); followed by excess maternal weight gain among obese (relative risk 1.5) and gestational diabetes mellitus (relative risk 1.4). Conclusions: Obesity, excessive maternal weight gain, and GDM all are associated with LGA. Decreasing the prevalence of obesity also reduce the prevalence of LGA fetuses apart from controlling excess maternal weight gain.

Keywords

• Gestational diabetes mellitus
• Obesity
• Large for gestational age
• ultrasonography
• Maternal weight gain