MATERNAL NUTRITIONAL-STATUS, DIABETES AND RISK OF MACROSOMIA AMONG NATIVE-CANADIAN WOMEN

Multivariate methods were used to identify risk factors for macrosomia (birth weight > 4000 g) among 741 singleton births to Native Canadian women from Sioux Lookout Zone, Ontario, Canada, in 1990-1993. The ave rage birth weight was 3691 +/- 577 g, and 29.2% of infants weighed mor e than 4000 g at birth. Macrosomic infants were born at later gestatio nal ages and were more likely to be male. Women delivering macrosomic infants were taller, entered pregnancy with higher body mass indexes ( BMI) and gained more weight during pregnancy, but were less likely to smoke cigarettes. They were more likely to have previously delivered a macrosomic infant and to have had gestational diabetes mellitus (GDM) . Risk of macrosomia was associated with maternal glycemic status; wom en with pre-existing diabetes were at greatest risk, followed by those with GDM A(2) (fasting glucose greater than or equal to 6 mmol/l). Wo men with GDM A(1) (fasting glucose <6 mmol/l) were not at increased ri sk for delivering a macrosomic infant, but glucose-tolerant women with high glucose concentrations 1 h after the 50 g challenge were at some what increased risk. Maternal glycemic status and maternal nutritional status before and during pregnancy are important determinants of macr osomia in this native population. (C) 1998 Elsevier Science Ireland Lt d.