Prevalence of large-for-gestational-age and macrosomia newborns in South China, 2014-2021: a large population-based cross-sectional study

Abstract

Background: Infants categorized as large for gestational age (LGA) or with macrosomia face an increased risk of adverse pregnancy outcomes and metabolic syndrome. However, the epidemiological characteristics of LGA and macrosomia are not well understood. This study aims to describe these characteristics in detail.

Methods: Descriptive statistical methods were employed to analyze the prevalence of large for gestational age (LGA) and macrosomia, as well as their distribution from 2014 to 2021, using data from the Guangdong Women and Children Health Information System. Retrospective data on birthweight, gender, method of delivery, maternal age, and household registration were collected. Additionally, the correlation between prevalence rates and gross domestic product (GDP) per capita was assessed.

Results: The study included data from 12,992,558 singleton live births for LGA and 12,999,759 for macrosomia. The overall prevalence of LGA and macrosomia in southern China between 2014 and 2021 was 8.59% and 2.33%, respectively. During the study period, the prevalence of LGA in preterm infants (13.64%) was significantly higher than in full-term infants (8.34%), while macrosomia occurred more frequently in full-term infants (2.43%) and male infants (2.98%). The prevalence of LGA and macrosomia in winter was 9.94% and 2.59%, respectively, much higher than in other seasons. Additionally, the rate of LGA and macrosomia among infants born to mothers of advanced maternal age (≥ 35 years) was 13.52% and 3.57%, significantly higher than the 7.79% and 2.17% observed among those born to mothers younger than 35 years. Furthermore, the nine cities in the Pearl River Delta region accounted for the majority of LGA and macrosomia cases in southern China from 2014 to 2021.

Conclusions: Between 2014 and 2021, the overall birth rate in southern China showed a declining trend, while the prevalence of large for gestational age (LGA) and macrosomia increased. The liberalization of China's birth policy, coupled with the rise in advanced maternal and paternal ages, contributed to the higher rates of LGA and macrosomia. Additionally, most LGA infants may be born at an earlier gestational age. LGA and macrosomia are more commonly observed in winter, with birth peaks occurring at the beginning of the following year.

Keywords: Large-for-gestational age; Macrosomia; Preterm; Season.