Maternal pre-pregnancy body mass index, hemoglobin concentration, and gestational diabetes as predictors of neonatal macrosomia: A retrospective study in Kenitra, Morocco

Mohamed Derdaki, Mohamed El Bakkali, Mustapha Zghaid, Nabil Ait Ouaaziz, Younes Laababid, Khalid Hafiani, Malika Elouardi, Abla Kourisna, Yassmine Nahab, Amine Arfaoui, Ali Quyou, Moulay Laarbi Ouahidi

Abstract

Neonatal macrosomia is a major perinatal complication associated with maternal metabolic disorders. This study aimed to assess whether hemoglobin concentration and gestational diabetes mediate the association between pre-pregnancy body mass index and neonatal macrosomia. A retrospective analysis was conducted among 700 singleton full-term pregnancies at El Idrissi Provincial Hospital, Kenitra, Morocco. Macrosomia was defined as birth weight ≥4000 g, and elevated hemoglobin as ≥12.5 g/dL. Gestational diabetes was diagnosed using fasting glucose or a 75-g oral glucose tolerance test. Mediation analysis using the Karlson–Holm–Breen method was adjusted for maternal age, parity, gestational hypertension, and infant sex. The prevalence of gestational diabetes was 11.9%, and macrosomia occurred in 14.7% of cases. Overweight and obesity were significantly associated with macrosomia, and 71.86% (overweight) and 67.52% (obesity) of these associations were jointly explained by hemoglobin concentration and gestational diabetes, mainly through gestational diabetes. Early metabolic screening during pregnancy may reduce the risk of adverse birth outcomes.

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