The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: Results from a prospective multicentre study

Salvatore Alberico, Marcella Montico, Valentina Barresi, Lorenzo Monasta, Caterina Businelli, Valentina Soini, Anna Erenbourg, Luca Ronfani, Gianpaolo Maso, Daniele Domini, Claudio Fiscella, Sara Casarsa, Carlo Zompicchiatti, Michela De Agostinis, Attilio D'atri, Raffaella Mugittu, Santo La Valle, Cristina Di Leonardo, Valter Adamo, Silvia SmiroldoGiovanni Del Frate, Monica Olivuzzi, Silvio Giove, Maria Parente, Daniele Bassini, Simona Melazzini, Secondo Guaschino, Monica Piccoli, Sergio Demarini, Diego Marchesoni, Alberto Rossi, Giorgio Simon, Giorgio Tamburlini

Research output: Contribution to journalArticlepeer-review


Background: It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia.Methods: A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample included 14109 women with complete records. Associations between exposure variables and newborn macrosomia were analyzed using Pearson's chi squared test. Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia.Results: Maternal obesity (adjusted OR 1.7, 95% CI 1.4-2.2), excessive gestational weight gain (adjusted OR 1.9, 95% CI 1.6-2.2) and diabetes (adjusted OR 2.1, 95% CI 1.5-3.0 for gestational; adjusted OR 3.0, 95% CI 1.2-7.6 for pre-gestational) resulted to be independent predictors of macrosomia, when adjusted for other recognized risk factors. Since no significant interaction was found between pre-gestational BMI and gestational weight gain, excessive weight gain should be considered an independent risk factor for macrosomia. In the sub-group of women affected by gestational or pre-gestational diabetes, pre-gestational BMI was not significantly associated to macrosomia, while excessive pregnancy weight gain, maternal height and gestational age at delivery were significantly associated. In this sub-population, pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia.Conclusions: Our findings indicate that maternal obesity, gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia. To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored.

Original languageEnglish
Article number23
JournalBMC Pregnancy and Childbirth
Issue number1
Publication statusPublished - Jan 15 2014


  • Body mass index
  • Gestational diabetes mellitus
  • Newborn macrosomia
  • Pregnancy
  • Weight gain

ASJC Scopus subject areas

  • Obstetrics and Gynaecology


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