Risk Factors for Macrosomia in Multipara: A Multi-Center Retrospective Study

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Neonatal Research

Background:

• China's evolving fertility policies (two-child, three-child) have coincided with an increased incidence of macrosomia.
• Limited research exists on macrosomia risk factors among multiparous women under these new policies.
• Macrosomia presents a significant public health challenge, necessitating updated prevention strategies.

Purpose of the Study:

• To determine the incidence and recurrence rates of macrosomia in multiparous women in China.
• To identify independent risk factors associated with macrosomia in multiparous women.
• To provide a scientific basis for developing effective macrosomia prevention strategies for multiparous women.

Main Methods:

• A multi-center retrospective study involving 6200 women with two consecutive deliveries.
• Data collected from 18 hospitals across 12 Chinese provinces between January and October 2018.
• Logistic regression analysis used to identify risk factors for macrosomia (defined as birth weight ≥ 4000 g).

Main Results:

• The incidence of macrosomia among multipara was 7.6% (470/6200).
• The recurrence rate of macrosomia in multipara was 27.2% (121/445).
• Independent risk factors identified: higher prepregnancy BMI, greater gestational weight gain, prior history of macrosomia, and longer subsequent gestation.

Conclusions:

• Multipara with a history of macrosomia require targeted healthcare education and preconception counseling.
• Promoting optimal prepregnancy BMI and managing gestational weight gain are crucial for preventing macrosomia.
• These findings support the development of evidence-based interventions to mitigate macrosomia risks in China's evolving demographic landscape.