ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1590283
This article is part of the Research TopicMaternal Metabolic Health: From Preconception to PostpartumView all 14 articles
Assessing the Risk Factors and Establishing Multivariable Prediction Models for Singleton Macrosomia
Provisionally accepted
- 1Obstetrics and Gynecology Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, China
- 2Department of Obstetrics and Gynecology, Quanzhou Women & Children’s Hospital, Quanzhou, China
- 3Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
- 4Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
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Introduction: Fetal macrosomia is related to adverse neonatal and maternal health outcomes. Therefore, we aimed to evaluate the risk factors for macrosomia and establish multivariable prediction models to enable early identification, prevention, and mitigation of its adverse outcomes. Methods: This retrospective case-control study included 800 singleton pregnant women who delivered in 2022 at Fujian Maternity and Child Health Hospital and Quanzhou Women and Children's Hospital. They were categorized into the macrosomia (birth weight [BW] ≥4,000 g, n = 400) and non-macrosomia (BW = 2500–3999 g, n = 400) groups according to the BW of the newborns. Prediction models in singleton fetuses during mid-to-late pregnancy and before delivery were constructed. Results: Maternal height ≥165 cm (odds ratio [OR] = 2.303, 95% confidence interval [CI]: 1.232– 4.305), pre-pregnancy overweight (OR = 2.166, 95% CI: 1.119–4.195), pre-pregnancy obesity (OR = 3.189, 95% CI: 1.020–9.968), excessive gestational weight gain in the second trimester (OR = 2.083, 95% CI: 1.250–3.470), and at least two abnormal blood glucose values in the oral glucose tolerance test (OR = 5.267, 95% CI: 1.814–15.29) were identified as risk factors for macrosomia. Additionally, maternal abdominal circumference (AC) plus fundal length ≥140 cm (OR = 6.283, 95% CI: 3.976– 9.927), fetal biparietal diameter ≥10 cm (OR = 3.373, 95% CI: 1.103–10.31), fetal head circumference ≥35 cm (OR = 3.473, 95% CI: 1.334–9.041), and fetal AC ≥36 cm at pre-delivery (OR = 23.46, 95% CI: 14.81–37.16) were risk factors for macrosomia. Discussion: The construction of the macrosomia prediction model in singleton fetuses during mid-to-late pregnancy and before delivery showed a strong predictive value. This study identified key high-risk factors for macrosomia during the perinatal period. The macrosomia prediction model developed here is expected to enable early identification of macrosomia, allowing for timely interventions aimed at reducing the risk of adverse perinatal outcomes.
Keywords: Macrosomia, predictive model, pre-pregnancy body mass index, gestational weightgain, gestational diabetes mellitus, Risk factors
Received: 09 Mar 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Luo, Huang, Luo, Deng, Lin, Liao, Yan and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jinfu Zhou, Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
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