Following the 2009 American Institute of Medicine recommendations for normal body mass index and overweight women led to an increased risk of fetal macrosomia among Taiwanese women

• Main Authors: Yieh-Loong Tsai, Kian-Mei Chong, Kok-Min Seow
• Format: Article
• Language: English
• Published: Elsevier 2013-09-01
• Series: Taiwanese Journal of Obstetrics & Gynecology
• Subjects: birth weight; body mass index; gestational weight gain; Institute of Medicine; macrosomia
• Online Access: http://www.sciencedirect.com/science/article/pii/S1028455913001149

Objective: This study aimed to investigate the risk of birth weights over 4000 g (macrosomia) in association with following the 2009 American Institute of Medicine (AIOM) recommendations. Materials and Methods: Seventy-six nondiabetic women who delivered a singleton, term macrosomic fetus and 82 women who delivered a singleton, term fetus weighing <4000 g were analyzed retrospectively. The relationship between the risk of macrosomia and gestational weight gain in different periods of pregnancy was investigated using logistic regression. Results: The incidence of macrosomia from January 2008 to December 2009 was 1.8% among the Taiwanese women. The incidences of cesarean delivery (54.5% vs. 18.2%, p < 0.001) and blood loss >1000 mL at delivery (35.5% vs. 6.1%, p < 0.0001) were associated with macrosomia. The risk of macrosomia among normal weight women with gestational weight gain greater than 13 kg increased four-fold [odds ratio (OR) = 4.88; 95% confidence interval (CI) 1.84–12.90]. For overweight women with total gestational weight gain >11.5 kg, the risk of macrosomia increased nine-fold (OR = 9.63; 95% CI 1.76–52.74). Conclusion: Macrosomia resulted in more cesarean deliveries and greater maternal blood loss at birth. In Taiwan, to prevent macrosomia, we suggest that the total gestational weight gain should be <11.5 kg among normal weight women and within 10 kg for overweight women.