Modifiable risk factors for term large for gestational age births

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Public Health

Background:

• Term large for gestational age (T-LGA) births pose risks to both mother and child.
• Identifying risk factors is crucial for developing targeted public health interventions.
• Previous research indicates various factors influence fetal growth, but specific modifiable risks require further elucidation.

Purpose of the Study:

• To identify modifiable and nonmodifiable risk factors for term large for gestational age (T-LGA) births in Northern and Central Alberta.
• To assess the public health significance of these identified risk factors.

Main Methods:

• A retrospective cohort study utilizing maternal and newborn data from a provincial perinatal database.
• Inclusion of singleton live births between 1996 and 2003 (n = 115,198).
• Statistical analysis adjusted for potential confounders to determine predictors of T-LGA births.

Main Results:

• Key predictors of T-LGA births included pre-pregnancy weight of 91 kg or greater, multiparity, and a history of previous large for gestational age (LGA) birth.
• Maternal pre-pregnancy weight of 91 kg or greater was the strongest modifiable predictor (OR = 2.52; CI 2.39, 2.65).
• The population-attributable risk percentage for pre-pregnancy weight of 91 kg or greater was 10%.

Conclusions:

• Elevated pre-pregnancy maternal weight is a significant, modifiable risk factor for T-LGA births.
• Public health strategies should focus on weight management in women of childbearing age.
• Multiparity and prior LGA births are important nonmodifiable risk factors to consider in T-LGA prevention efforts.