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Maternal Body Mass Linked to Rising Rate of Large for Gestational Age Births

Increases in maternal body mass index and decreases in maternal smoking are behind the increasing trend in large-for-gestational-age (LGA) births. The proportion of infants weighing more than 4 kg at birth has increased significantly over the past decade in Sweden, North America, and Europe.

High birth weight is associated with increased complications for mothers and their newborns.Pamela J. Surkan from Harvard School of Public Health in Boston, Massachusetts, and colleagues used the Swedish Birth Registry to examine whether a change in rate of LGA births over time could be explained by a change in maternal risk factors.

Between 1992 and 2001, the proportion of LGA infants increased from 3.32% to 3.86%, the authors report, and the proportion of infants weighing at least 4.5 kg increased from 3.71% to 4.60%.

During the same interval, the prevalence of maternal body-mass index (BMI) of 25 or more increased from 25.4% to 35.5% and the prevalence of daily smoking decreased from 22.9% to 10.9%.

Overweight women (BMI 25.0-29.9) were twice as likely and obese women (BMI 30.0 or more) were more than three times as likely as women with normal BMI (20.0-24.9) to have LGA infants, the researchers note.

Ms. Surkan stated that, "this study indicates yet another reason why physicians should encourage women of child bearing age to maintain a normal weight,"

"Given the worldwide trends of increases in overweight among children and adolescents, LGA births are likely to become an even more serious problem," the authors conclude. "Our results suggest that addressing the problem of overweight and obesity in women of child bearing age will be an even more important task in the future."

"Preventing overweight necessitates intervention among children and adolescents," Surkan added. "We need to develop successful intervention tools that aim at reducing overweight among these groups."

Obstet Gynecol 2004;104:720-726.

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FACT:

Most people with diabetes die of cardiovascular diseases. In fact, 75% of people with diabetes die of cardiovascular diseases. Men with diabetes are 2 times more likely than the general population to have a heart attack. Women with diabetes have a risk 4 times greater.