ArticleFrontiers in nutrition2025
Pre-pregnancy body mass index and risk of macrosomia: glycemic status-specific thresholds and subgroup interactions in a prospective cohort.
Article in Frontiers in nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Potential for primary prevention of low birth weight in pregnancies with and without gestational diabetes mellitus: a prospective cohort study in Central China.BMC pregnancy and childbirth · 2026Article
- Association of menarche age with macrosomia and modified effect from dietary pattern: findings from the Chinese pregnant women.Frontiers in nutrition · 2026Article
- Association of culture-detected vaginal microbiota and body composition parameters with gestational diabetes outcomes.Frontiers in cellular and infection microbiology · 2026Observational
- Fair Play a Tavola: a school-based framework integrating nutrition education and anthropometric screening for early identification of excess weight in preschool children.Frontiers in pediatrics · 2026Article
- Obesity and Its Role in Fetal Programming-A Narrative Review.Nutrients · 2025Review
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5 authors.
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Abstract
Background: Macrosomia, a critical perinatal complication, is closely linked to maternal obesity and gestational diabetes mellitus (GDM). However, the extent to which GDM status modifies the association between pre-pregnancy body mass index (BMI) and macrosomia, particularly across demographic subgroups, remains poorly understood. This study aimed to quantify glycemic status-specific risk thresholds and explore subgroup interactions in a large prospective cohort. Methods: In this prospective cohort study, 34,031 women initiating antenatal care before 14 weeks of gestation were enrolled at a tertiary hospital in Central China (2013-2019). Participants were stratified by GDM status and pre-pregnancy BMI categories. Multivariable logistic regression, restricted cubic spline (RCS) models, and interaction analyses evaluated associations between BMI and macrosomia (birth weight ≥ 4,000 g), adjusting for sociodemographic, behavioral, and clinical covariates. Results: Macrosomia incidence was markedly higher in GDM (6.2%) vs. non-GDM pregnancies (3.6%). Adjusted models revealed a steeper dose-response gradient in GDM: each 1-unit BMI increase conferred 24% higher odds (aOR: 1.24 [95% CI 1.20, 1.28]) in GDM vs. 13% (aOR: 1.13 [1.11, 1.15]) in non-GDM. Obesity amplified risk 6.80-fold (aOR: 6.80 [4.02, 11.51]) in GDM vs. 4.70-fold (aOR: 4.70 [3.12, 7.10]) in non-GDM. RCS models identified nonlinear trajectories in both GDM and non-GDM pregnancies (reference level: 22.94 kg/m Conclusion: GDM status modifies pre-pregnancy BMI-associated macrosomia risks, with distinct thresholds and subgroup vulnerabilities. These findings necessitate glycemic status-specific clinical guidelines and precision interventions targeting high-risk subgroups. Universal preconception weight optimization remains pivotal for non-GDM populations. This study underscores the urgency of integrating metabolic and demographic heterogeneity into perinatal care to mitigate the dual epidemics of overweight/obesity and GDM.
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