Correlations between body composition of early pregnant women and macrosomia risk
ZHANG Can1,2, LIU Jie1, ZHANG Haiyan2, FAN Zhonggui2, LUO Li2, XU Hongxia1
1.Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing 400042, China; 2.Maternal Nutrition Clinic, Chongqing Yongchuan District Maternity and Child Health Hospital, Chongqing 402160, China
Abstract:Objective To explore the association between body composition of early pregnant women and macrosomia risk.Methods We retrospectively included 1697 pregnant women who had given birth in Yongchuan Maternity and Child Health Hospital of Chongqing between January and September in 2016. Macrosomia related risk factors as well as body composition of early pregnant women were investigated and follow-up was performed until the cessation of pregnancy. Logistic regression analysis was used to explore the association between macrosomia and potential risk factors, including body composition of early pregnant women.Results BMI of early pregnancy, body fat weight and body fat percentage were independent risk factors for macrosomia. Fat-free mass was an independent protective factor. Early pregnant women with BMI≥28 were 3.75 times as likely to have macrosomic newborns as those with normal BMI (18.5-23.9). Similarly, pregnant women with fat weight greater than 0.28 times body weight were 4.21 times as vulnerable as those with fat weight less than 0.2 times body weight. Pregnant women with a body fat percentage≥30% were 1.86 times as vulnerable as those with a body fat percentage<30%. Pregnant women with fat-free mass greater than 0.8 times body weight had a 76% decreased risk for macrosomic newborns.Conclusions BMI and body composition of early pregnancy are associated with macrosomia risk. Nutrition and exercise interventions are recommended in those early pregnant women with obesity and excessive body fat to reduce the risk of macrosomia.
张灿, 刘洁, 张海燕, 樊中桂, 罗丽, 许红霞. 孕早期孕妇体成分与分娩巨大儿的相关性[J]. 武警医学, 2019, 30(9): 764-768.
ZHANG Can, LIU Jie, ZHANG Haiyan, FAN Zhonggui, LUO Li, XU Hongxia. Correlations between body composition of early pregnant women and macrosomia risk. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(9): 764-768.
American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins -Obstetrics. Practice bulletin No. 173: fetal macrosomia[J]. Obstet Gynecol,2016, 128(5): e195-e209.
[2]
Hamilton B E, Martin J A, Osterman M J, et al.Births:final data for 2014[J].Natl Vital Stat Rep,2015,64(12):1-64.
King J R, Korst L M, Miller D A, et al. Increased composite maternal and neonatal morbidity associated with ultrasonographically suspected fetal macrosomia[J]. Matern Fetal Neonatal Med, 2012, 25(10):1953-1959.
Henriksen T .The macrosomic fetus: a challenge in current obstetrics[J]. Acta Obstet Gynecol Scand, 2008, 87(2):134-145.
[7]
Walsh J M, McAuliffe F M. Prediction and prevention of the macrosomic fetus[J]. Eur J Obstet Gynecol Reprod Biol, 2012, 162(2):125-130.
[8]
Jolly M C, Sebire N J, Harris J P, et al. Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies[J]. Eur J Obstet Gynecol Reprod Biol, 2003, 111(1): 9-14.
[9]
Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden[J]. Int J Gynaecol Obstet, 2006, 93(3): 269-274.
[10]
Lukaski H C, Johnson P E, Bolonchuk W W, et al. Assessment of fat-free mass using bioelectrical impedance measurements of the human body [J]. Am J Clin Nutr, 1985, 41(4): 810-817.
[11]
Villar J, Cogswell M, Kestler E, et al. Effect of fat and fat-free mass deposition during pregnancy on birth weight[J]. Am J Obstet Gynecol, 1992, 167(5): 1344-1352.
Butte N F, Ellis K J, Wong W W, et al. Composition of gestational weight gain impacts maternal fat retention and infant birth weight[J]. Am J Obstet Gynecol, 2003, 189(5):1423-1432.
[14]
Lederman S A, Paxton A , Heymsfield S B, et al. Maternal body fat and water during pregnancy: do they raise infant birth weight [J]. Am J Obstet Gynecol, 1999, 180(1 Pt 1):235-240.
[15]
Gernand A D, Christian P, Paul R R, et al.Maternal weight and body composition during pregnancy are associated with placental and birth weight in rural Bangladesh[J]. J Nutr,2012, 142(11): 2010-2016.
Forsum E, Sadurskis A, Wager J. Resting metabolic rate and body composition of healthy Swedish women during pregnancy[J]. Am J Clin Nutr, 1988, 47(6):942-947.
[20]
Liu P, Xu L, Wang Y, et al. Association between perinatal outcomes and maternal pre-pregnancy body mass index [J]. Obes Rev, 2016,17(11): 1091-1102.