Prevalence and associated factors of macrosomia among prenant women with gestational diabetes mellitus at Hai Phong Obstetrics and Gynecology Hospital

Abstract

Objective: This study pursued two aims: (1) to determine the prevalence of macrosomia and (2) to identify factors associated with macrosomia among women with gestational diabetes mellitus (GDM) delivering at Hai Phong Obstetrics and Gynecology Hospital. Methods: Objective 1: A cross sectional descriptive study was conducted using convenience sampling of 3,164 women with GDM who delivered at the hospital from January 2021 to December 2024. Objective 2: A case–control study was carried out on 117 GDM women who delivered macrosomic infants (cases) and 234 GDM women who delivered non macrosomic infants (controls) during the same period and setting. Results: The prevalence of macrosomia among women with GDM was 3.95%. Univariate logistic regression analysis identified the following factors as increasing the risk of macrosomia: maternal age ≥ 30 years, parity ≥ 3, diet-only treatment, BMI, serum glucose, and HbA1c at the end of pregnancy. Intellectual labor (white-collar occupation) was found to be a protective factor. Multivariate logistic regression analysis revealed that only three variables were independently and significantly associated with macrosomia: Serum glucose at the end of pregnancy (OR = 1.33, 95% CI: 1.12 – 1.56, p = 0.001),  BMI at the end of pregnancy (OR = 1.11, 95% CI: 1.03 – 1.20, p = 0.006), and HbA1c at the end of pregnancy (N=107, OR = 2.29, 95% CI: 1.34 – 3.92, p = 0.002). Conclusion: The prevalence of macrosomia among women with gestational diabetes mellitus (GDM) was 3.95%. Elevated serum glucose levels, higher body mass index (BMI), and increased hemoglobin A1c (HbA1c) levels at the end of pregnancy were independently associated with a higher risk of macrosomia in this population.