OBJECTIVETo understand the awareness rate of macrosomia related knowledge and influencing factors among pregnant women in Zhejiang province and provide evidence for the improvement of pre-gestational and prenatal care.

METHODSA face to face questionnaire survey was conducted among 1 512 pregnant women selected through multistage cluster random sampling from 20 counties (district) in Zhejiang. Macrosomia-related awareness and related factors were analyzed.

RESULTSA total of 1 494 valid questionnaires were analyzed, the awareness rate was 40.7% for macrosomia diagnostic criteria (95% CI: 38.2%-43.2%), 55.0% for the cause of macrosomia (95% CI: 52.4%-57.6%) and 62.4% for prevention related knowledge (95% CI: 59.9%-64.9%) and the awareness rate of both the cause and the prevention related knowledge was 49.0% (95% CI: 46.4%-51.6%). Multivariate logistic regression analysis showed that the third trimester of pregnancy (OR = 1.906, 95% CI: 1.128-3.221), urban residence (OR = 1.335, 95% CI: 1.014-1.756), educational level of junior college (OR = 2.474, 95% CI: 1.635-3.744) and educational level of regular college or above (OR = 2.072, 95% CI: 1.338-3.209), receiving health education about health pregnancy (OR = 1.936, 95% CI: 1.509-2.484) and self-learning about the knowledge of health pregnancy (OR = 2.065, 95%CI: 1.338-3.189) were the influencing factors to the awareness rate of macrosomia diagnostic criteria and prevention related knowledge of macrosomia among pregnant women. The awareness rate of the cause and prevention related knowledge of macrosomia was higher in older age group (OR = 2.103, 95% CI: 1.330-3.323).

CONCLUSIONAmong the pregnant women in Zhejiang, the awareness rate of macrosomia diagnostic criteria was less than 50%. Therefore, it was necessary to strengthen the health education during pre-gestational and gestational periods among reproductive women, especially the education about pregnancy health in rural area.

China ; epidemiology ; Female ; Fetal Macrosomia ; epidemiology ; Health Knowledge, Attitudes, Practice ; Humans ; Pregnancy ; Pregnant Women ; psychology ; Surveys and Questionnaires

To analyze the trend of abnormal birth weight of full-term newborns and its correlation with parental reproductive age in Chongqing municipality from 2010 to 2022. Based on the Chongqing Birth Certificate System, full-term newborns born from January 2010 to December 2022 were selected. Parental information and birth weight were abstracted from the system. The joinpoint regression model was used to assess the trend of incidence of low birth weight (LBW) and macrosomia in the offspring from 2010 to 2022. The logistic regression model was utilized to analyze the association between parental reproduction age and birth weight of newborns. The average birth weight of 3 155 542 newborns was (3 305.8±410.5) g. The joinpoint regression model showed a decreasing trend for the incidence of LBW from 2010 to 2016 (APC=-4.26%, P<0.05), and an increasing trend from 2020 to 2022 (APC=8.99%, P<0.05). The incidence of macrosomia exhibited a decreasing trend from 2015 to 2022 (APC=-3.37%, P<0.05). The logistic regression model showed that, compared to the group with parents aged 20-34 years, the risk of LBW increased in other age groups. The risk of macrosomia decreased when either parent was aged<20 years, and increased when both parents were aged≥20 years. In conclusion, from 2010 to 2022, the incidence of LBW in full-term offspring in Chongqing municipality decreased first and then increased, and the incidence of macrosomia increased first and then decreased. Both young and advanced parental age were associated with an increased risk of LBW in offspring, and advanced parental age was also associated with an increased risk of macrosomia in offspring. Attention should be paid to the effects of advanced maternal and paternal age on offspring birth weight. Further efforts to control childbearing at a young age were needed.
Female ; Infant, Newborn ; Humans ; Birth Weight ; Fetal Macrosomia/epidemiology* ; Infant, Low Birth Weight ; Reproduction ; Weight Gain ; Parents

To analyze the trend of abnormal birth weight of full-term newborns and its correlation with parental reproductive age in Chongqing municipality from 2010 to 2022. Based on the Chongqing Birth Certificate System, full-term newborns born from January 2010 to December 2022 were selected. Parental information and birth weight were abstracted from the system. The joinpoint regression model was used to assess the trend of incidence of low birth weight (LBW) and macrosomia in the offspring from 2010 to 2022. The logistic regression model was utilized to analyze the association between parental reproduction age and birth weight of newborns. The average birth weight of 3 155 542 newborns was (3 305.8±410.5) g. The joinpoint regression model showed a decreasing trend for the incidence of LBW from 2010 to 2016 (APC=-4.26%, P<0.05), and an increasing trend from 2020 to 2022 (APC=8.99%, P<0.05). The incidence of macrosomia exhibited a decreasing trend from 2015 to 2022 (APC=-3.37%, P<0.05). The logistic regression model showed that, compared to the group with parents aged 20-34 years, the risk of LBW increased in other age groups. The risk of macrosomia decreased when either parent was aged<20 years, and increased when both parents were aged≥20 years. In conclusion, from 2010 to 2022, the incidence of LBW in full-term offspring in Chongqing municipality decreased first and then increased, and the incidence of macrosomia increased first and then decreased. Both young and advanced parental age were associated with an increased risk of LBW in offspring, and advanced parental age was also associated with an increased risk of macrosomia in offspring. Attention should be paid to the effects of advanced maternal and paternal age on offspring birth weight. Further efforts to control childbearing at a young age were needed.
Female ; Infant, Newborn ; Humans ; Birth Weight ; Fetal Macrosomia/epidemiology* ; Infant, Low Birth Weight ; Reproduction ; Weight Gain ; Parents

BACKGROUND: Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China. METHODS: A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed. RESULTS: In 6204 participants, there are 1002 women (1002/6204,16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P  < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P  = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P  = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P  = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P  = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further. CONCLUSIONS The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.
Adult ; Blood Glucose/metabolism* ; China/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Diabetes, Gestational ; Female ; Fetal Macrosomia ; Glucose Intolerance ; Humans ; Male ; Pregnancy ; Retrospective Studies

Objective: To investigate the risks of pre-pregnancy overweight, excessive gestational weight gain on macrosomia. Methods: We conducted one hospital-based cohort study, focusing on pregnant women from January 2015. All pregnant women attending to this hospital for maternal check-ups, were included in our cohort and followed to the time of delivery. Data related to general demographic characteristics, pregnancy and health status of those pregnant women, was collected and maternal pre-pregnant BMI and maternal weight gain were calculated. Logistic regression was used to explore the risk difference of pre-pregnancy BMI, excessive gestational weight gain on macrosomia. Results: The overall incidence of macrosomia in our cohort appeared as 6.6% (149/2 243). After adjusting the confounding factors including age and histories on pregnancy, pre-pregnancy overweight/obesity was associated with higher risks of macrosomia (OR=3.12, 95%CI: 1.35-7.22, P=0.008; OR=2.99, 95%CI: 1.17-7.63, P=0.022) when comparing to those with normal pre-pregnancy weight. Cesarean delivery and sex of the offspring were associated with higher risk of macrosomia, while excessive gestational weight gain showed no significant difference (OR=1.41, 95%CI: 0.96-2.09, P=0.084). Our data showed that Macrosomia was statistically associated with gestational weight gain (P=0.002). After controlling parameters as age, history of pregnancy and related complications of the pregnant women, results from the logistic regression showed that women with gestational inadequate weight gain having reduced risks to deliver macrosomia, when compared to those pregnant women with adequate weight gain (OR=0.52, 95%CI: 0.30-0.90, P=0.019). Conclusion: Pre-pregnancy overweight and obesity were on higher risks to macrosomia.
Body Mass Index ; Cesarean Section/statistics & numerical data* ; China/epidemiology* ; Female ; Fetal Macrosomia/epidemiology* ; Humans ; Incidence ; Logistic Models ; Obesity/epidemiology* ; Overweight/epidemiology* ; Pregnancy ; Pregnancy Complications/epidemiology* ; Prospective Studies ; Weight Gain

BACKGROUNDUse of an emergency peripartum hysterectomy (EPH) as a lifesaving measure to manage intractable postpartum hemorrhage (PPH) appears to be increasing recently around the world, and the indications for EPH have changed. The object of this study is to identify risk factors associated with EPH.

METHODSWe conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1, 2005 and June 30, 2013, at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University, School of Medicine (IPMCH). The parametric t-test, chi-square tests and Logistic regression models were used for analysis to identify the risk factors. The results were considered statistically significant when P < 0.05.

RESULTSThere were 89 178 deliveries during the study period. Twenty-one women had an EPH, with an incidence of 24 per 100 000 deliveries. The loss of blood during postpartum hemorrhage of the EPH group was (5 060.7 ± 3 032.6) ml, and that of the control group was (2 040.8 ± 723.5) ml. There was a significant difference of PHH between the EHP group and the control group (P = 0.001). Independent risk factors for EPH from a logistic regression model were: disseminated intravascular coagulation (DIC) (OR: 9.9, 95% CI 2.8-34, P = 0.003), previous cesarean section (OR: 5.27; 95% CI: 1.48-17.9, P = 0.009), placenta previa (OR: 6.9; 95% CI 1.6-2.9, P = 0.008), the loss of PPH (OR: 1.001; 95% CI 1.001-1.002, P = 0.002), placenta accreta (OR: 68; 95% CI 10-456, P = 0.004), the use of tocolytic agents prenatally (OR: 6.55, 95%CI 1.34-32.1,P = 0.049), and fetal macrosomia (OR: 6.9, 95% CI 1.25-38, P = 0.049).

CONCLUSIONSignificant risk factors of EPH are DIC, placenta previa, PPH, previous cesarean delivery, and placenta accrete, the use of tocolytic agents prenatally, and fetal macrosomia.

Adult ; Case-Control Studies ; Emergencies ; Female ; Fetal Macrosomia ; complications ; Humans ; Hysterectomy ; statistics & numerical data ; Middle Aged ; Obstetric Labor Complications ; epidemiology ; Placenta Accreta ; surgery ; Postpartum Hemorrhage ; surgery ; Pregnancy ; Risk Factors ; Tocolytic Agents ; adverse effects

Objective: To understand the effect of interpregnancy interval (IPI) of childbearing aged women on the birth weight of single live birth neonates in Shaanxi province. Methods: A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 20l0-2013, all the childbearing aged women had definite pregnancy outcomes. The interpregnancy interval of the childbearing aged women and the birth weight of the newborns were used as the independent variables and dependent variables respectively in multiple linear regression model and quantile regression model, and confounding factors were controlled. Results: A total of 13 063 women at childbearing age and their infants were investigated. The incidence of low birth weight and macrosomia was 3.54% and 7.62% respectively. Multiple linear regression analysis showed that there was no significant difference in birth weight among different IPI group and control group. Quantile regression analysis showed when birth weight was at 5 percentiles, the difference in birth weight between newborns whose mothers had short interpregnancy interval (<12 months) and those in control group was significant, when the birth weight was ≥90 percentiles, the birth weights of newborns whose mothers had long interpregnancy interval (60-119 months) were higher than those in control group, the difference was significant. As the increase of the percentiles of birth weight, the extent of changes gradually increased. Conclusion: The analysis indicated that both short (<12 months) and long (60-119 months) interpregnancy interval would had negative effects on birth weights of newborns. Therefore, planning for pregnancy is important for having a good perinatal outcome.
Birth Intervals ; Birth Weight ; Female ; Fetal Macrosomia/epidemiology* ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Live Birth ; Macrolides ; Male ; Maternal Age ; Mothers ; Pregnancy ; Pregnancy Outcome ; Risk Factors ; Surveys and Questionnaires