Clinical risk factors for fetal macrosomia

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Relevance: The prevalence of fetal macrosomia is steadily increasing worldwide and reaches up to 20%. Fetal macrosomia complicates the course of pregnancy and birth, leading to the increase in the number of emergency caesarean sections and perinatal losses by 1.5–3 times. Current prediction strategies are inaccurate, and most patients with fetal macrosomia are sent to labor with the “unknown status”. Current prognostic strategies are inaccurate, and the majority of patients with fetal macrosomia go into labor with the "unknown status".

Objective: To assess the clinical and laboratory risk factors for fetal macrosomia with subsequent development of prognostic mathematical models.

Materials and methods: The case-control study included 110 female patients. Group I (the main group) consisted of 30 patients with gestational diabetes mellitus (GDM). Group II (the control group) consisted of 80 women without GDM. The patients were stratified into four subgroups: Ia and 1b, IIa and IIb) depending on the presence of absence of fetal macrosomia and GDM. The clinical and laboratory risk factors were determined using univariate and multivariate logistic regression.

Results: Risk factors for the development of macrosomia included parity, body mass index before and during pregnancy, macrosomia in history, body weight of the pregnant woman and her partner (baby’s father) at birth, triglyceride and glucose levels at 24–28 weeks of pregnancy, estimated fetal weight during the 3rd ultrasound screening, and baby’s gender. Based on the obtained clinical and laboratory data, mathematical prediction models of macrosomia were constructed. The sensitivity was 100–78%, and specificity was 85–50%, the AUC was 0.76–0.77.

Conclusion: The developed mathematical models can be used to predict the development of fetal macrosomia at or after 24 weeks of pregnancy, both independently of the presence of GDM (also in the group with unknown GDM status) and can be used separately in the group of women with carbohydrate metabolism disorders.

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作者简介

Natalia Frankevich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

编辑信件的主要联系方式.
Email: natasha-lomova@yandex.ru
ORCID iD: 0000-0002-6090-586X

Dr. Med. Sci., Senior Researcher at the Department of Obstetrics

俄罗斯联邦, 117997, Moscow, Ac. Oparina str., 4

Alisa Tokareva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: alisa.tokareva@phystech.edu
ORCID iD: 0000-0001-5918-9045

PhD (in Physics and Mathematics), specialist at the Laboratory of Clinical Proteomics

俄罗斯联邦, 117997, Moscow, Ac. Oparina str., 4

Tamara Karapetyan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: tomamed02@mail.ru
ORCID iD: 0000-0003-0025-3182

Dr. Med. Sci., Senior Researcher at the Department of Obstetrics

俄罗斯联邦, 117997, Moscow, Ac. Oparina str., 4

Anastasia Kutsenko

Siberian State Medical University, Ministry of Health of Russia

Email: maori.nastya@yandex.ru
ORCID iD: 0009-0007-6146-561X

PhD student, Department of Obstetrics and Gynecology

俄罗斯联邦, 634050, Tomsk, Moskovsky tract, 2

Angela Vasilyeva

Siberian State Medical University, Ministry of Health of Russia

Email: angela.grigorjevna@yandex.ru
ORCID iD: 0009-0006-7975-1115

applicant at the Department of Obstetrics and Gynecology

俄罗斯联邦, 634050, Tomsk, Moskovsky tract, 2

Vitaly Chagovets

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: v_chagovets@oparina4.ru
ORCID iD: 0000-0002-5120-376X

PhD (in Physics and Mathematics), Head of the Laboratory of Metabolomics and Bioinformatics

俄罗斯联邦, 117997, Moscow, Ac. Oparina str., 4

Vladimir Frankevich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Siberian State Medical University, Ministry of Health of Russia

Email: v_frankevich@oparina4.ru
ORCID iD: 0000-0002-9780-4579

Dr. Sci. (in Physics and Mathematics), Director for Science – Head of the Department of Systems Biology in Reproduction, Institute of Translational Medicine

俄罗斯联邦, 117997, Moscow, Ac. Oparina str., 4; 634050, Tomsk, Moskovsky tract, 2

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2. Figure 1. Operating curves of parameters—potential markers of macrosomia

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3. Figure 2. Operating curves of models: a) model using data from and including the third screenings; b) model not using the results of the third screening, constructed during cross-validation (red) and validation on the test cohort (black)

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