HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) In Brief TRACK Discussion: Submit a Comment Alert me when this article is cited Alert me when TRACK Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Asplund, C. A. Articles by Olsen, C. PubMed PubMed Citation Articles by Asplund, C. A. Articles by Olsen, C.

Percentage Change in Antenatal Body Mass Index as a Predictor of Neonatal Macrosomia

¹ Eisenhower Army Medical Center, Fort Gordon, Georgia
² Uniformed Services University of the Health Sciences, Bethesda, Maryland

CORRESPONDING AUTHOR: Chad Asplund, MD, Department of Family Medicine, Eisenhower Army Medical Center, Fort Gordon, GA 30905, chad.asplund{at}osumc.edu

PURPOSE We wanted to evaluate the predictive value of percentage change in antenatal maternal body mass index (BMI) as it relates to macrosomia, as well as to compare change in pregnancy BMI with existing weight gain guidelines.

METHODS We analyzed data from 6 months of consecutive deliveries, focusing on first visit (first trimester) BMI, last visit (37 weeks or later) BMI, and fetal birth weight. Using regression and ² analyses, we evaluated the relationship between change in BMI and macrosomia.

RESULTS Of the 238 consecutive deliveries, we were able to analyze data from 186, of which 15.6% (n = 29) of the infants were macrosomic. Among macrosomic infants, 86.2% (25/29) of their mothers had a 25% or greater increase in BMI compared with 6.6% (10/157) of mothers of normal-weight infants (P <.001), for a relative risk 13.5% (95% confidence interval [CI], 7.3%–25.1%). Percentage change in BMI of 25% or greater had a sensitivity of 86.2% (95% CI, 68.3%–96.1%), a specificity of 93.6% (95% CI, 88.6%–96.9%), a positive predictive value of 71.4% (95% CI, 53.7%–85.4%), and a negative predictive value 97.4% (95% CI, 93.4%–99.3%) for macrosomia. Logistic regression adjusted for maternal age, race, parity, and gravidity showed that those women whose BMI increased 25% or greater were more than 200 times more likely (odds ratio [OR] = 219.3; 95% CI, 38.8–1,238.6; P <.001) to give birth to a macrosomic infant. Further adjusting for initial BMI strengthened the association (OR=1,062.4; 95% CI, 83.2–13,572.2; P < 001). Regardless of weight gain, when compared with Institute of Medicine weight gain recommendations, change in BMI or 25% or greater was associated with macrosomia (P <.001).

CONCLUSION Independent of initial pregnancy BMI or absolute weight gain, an increase in maternal BMI of 25% or greater during pregnancy is highly predictive of macrosomia.

Key Words: Fetal macrosomia • body mass index • pregnancy

This article has been cited by other articles:

				K. C. Stange In This Issue: Cohort Studies Ann. Fam. Med, November 1, 2008; 6(6): 482 - 482. [Full Text] [PDF]