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Saturday, March 15, 2014
Trailers (76): Factors contributing to LGA

Kim et al. Association of maternal body mass index, excessive weight gain, and gestational diabetes mellitus with large-for-gestational-age births

Why should you read about this topic?

Parsing the contributions of maternal factors related to LGA opens the doors to informative research into interventions

What were the authors trying to do?

Estimate the proportion of LGA (>90%ile) babies associated with maternal prepregnancy BMI>25, gestational weight gain (IOM, 2009), and GDM

Who participated and in what setting?

Live, singleton deliveries (N=660,038) at 37-41 weeks in FL between 2004 and 2008

What was the study design?

Retrospective, population-based analysis of birth certificates linked with Florida’s Hospital Inpatient Discharge Database

What were the main outcome measures?

LGA

What were the results?

LGA prevalence increased with increasing BMI, excessive weight gain, and GDM for all racial or ethnic groups.  Excessive weight gain contributed the highest population attributable proportion across all racial or ethnic groups, ranging from 33.3% to 37.7%

What is the most interesting image in the paper?

Figure 2

What were the study strengths and weaknesses?

Strengths: population-based; systematic adjustment for confounding. Weaknesses: birth certificate and administrative databases

What does the study contribute for your practice?

Excessive weight gain during pregnancy relates to a higher proportion of LGA babies than GDM or prepregnancy overweight and obesity

About the Author

William C. Dodson, MD
William C. Dodson, MD, is Professor of Obstetrics and Gynecology and Director of the Division of Reproductive Endocrinology and Infertility at Penn State College of Medicine. He completed his fellowship in reproductive endocrinology at Duke University. His research and clinical areas of focus include treatment of infertility, especially ovulation induction. He was previously on the Editorial Board of Obstetrics & Gynecology and has served as the Consultant Web Editor for Obstetrics & Gynecology since 2008.