Predicting the Risk of Macrosomia at Mid-Pregnancy Among Non-Diabetics: A Retrospective Cohort Study

Published:August 02, 2017DOI:



      To identify factors known in mid-pregnancy to be associated with risk of macrosomia (≥4000 g) among non-diabetic women and to develop a risk score to allow early identification of women at high risk.


      Data were obtained from a population-based perinatal database and a hospital laboratory database in Nova Scotia, Canada. The study included singleton live births born to non-diabetic women between 1998 and 2005. Logistic regression was used to identify risk factors significantly associated with macrosomia. Risk scoring systems were developed for nulliparous and parous women separately and validated using the C-statistic.


      Of the 23 857 mother-infant pairs included in the study, 16.7% of the infants were macrosomic. In nulliparous women, seven risk factors were identified, of which pre-pregnancy weight ≥90 kg with an OR of 4.8 (95% CI: 3.9 to 6.0) contributed a greater number of points to the risk score. The resulting risk score corresponded to a range of estimated risk of 0.2% to 47.0% and had a C-statistic of 0.70. In parous women, the most points were assigned to women with a previous large birth (OR: 3.7; 95% CI: 3.2–4.0) and a pre-pregnancy weight ≥90 kg (OR: 3.8; 95% CI: 3.1–4.7). The resulting risk score corresponded to a range of estimated risk of 0.4% to 88.0% and had a C-statistic of 0.75.


      Macrosomia risk can be estimated by a simple calculation based on a woman’s risk factor profile at mid-pregnancy.



      Mettre en évidence des facteurs qui, à la moitié de la grossesse, sont associés à un risque de macrosomie (≥4 000 g) chez les femmes non diabétiques, et mettre au point un score de risque permettant la détection précoce des femmes à risque élevé.


      Les données ont été tirées d’une base de données périnatales représentative de la population et d’une base de données de laboratoire en milieu hospitalier de la Nouvelle-Écosse. L’étude s’est penchée sur les naissances vivantes uniques survenues entre 1998 et 2005 pour lesquelles la mère ne souffrait pas de diabète. Les facteurs de risque présentant une association significative avec la macrosomie ont été mis en évidence par régression logistique, et des systèmes de scores de risque distincts ont été mis au point pour les femmes nullipares et pares, puis validés au moyen de la statistique C.


      Parmi les 23 857 paires mères-enfants retenues dans l’étude, 16,7 % des nouveau-nés présentaient une macrosomie. Chez les mères nullipares, sept facteurs de risque ont été mis en évidence; celui qui valait le plus de points dans le score de risque était un poids avant grossesse de 90 kg ou plus, associé à un rapport de cotes (RC) de 4,8 (IC à 95 % : 3,9–6,0). Le score de risque résultant correspondait à une étendue de risque estimé de 0,2 % à 47,0 %, et la statistique C était de 0,70. Chez les femmes pares, les facteurs qui comptaient le plus dans le score étaient la naissance précédente d’un bébé présentant une macrosomie (RC : 3,7; IC à 95 % : 3,2 à 4,0), ainsi qu’un poids avant grossesse de 90 kg ou plus (RC : 3,8; IC à 95 % : 3,1–4,7). Le score de risque résultant correspondait à une étendue de risque estimé de 0,4 % à 88,0 %, et la statistique C était de 0,75.


      Le risque de macrosomie peut être estimé par un simple calcul fondé sur le profil de risque de la femme à la moitié de la grossesse.

      Key Words


      GCT (glucose challenge test), GDM (gestational diabetes), LBW (low birth weight), MSAFP (maternal serum alpha-fetoprotein levels), NSAPD (Nova Scotia Atlee Perinatal Data), ROC (receiver operator characteristic)
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