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Prevalence of large‐for‐gestational age and macrosomia among livebirths in 23 low‐ and middle‐income countries between 2000 and 2021: An individual participant data analysis

Objective To examine the prevalence of large‐for‐gestational age (LGA) and macrosomia in 23 countries between 2000 and 2021. Design Descriptive multi‐country secondary data analysis. Setting Subnational, population‐based cohort studies (k = 45 for LGA, k = 25 for macrosomia) in 23 low‐ and middle‐...

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Main Authors: Kirakoya‐Samadoulougou, Fati, Ukwishaka, Joyeuse, Ngwasiri, Calypse, Subedi, Seema, Hazel, Elizabeth A., Erchick, Daniel J., Wu, Lee Shu Fune, Grandi, Carlos, Lachat, Carl, Toe, Laéticia Céline, Roberfroid, Dominique, Huybregts, Lieven, Labrique, Alain B., Rashid, Mabhubur, Shaikh, Saijuddin, Haque, Rezwanul, Baqui, Abdullah H., Saha, Samir K., Khanam, Rasheda, Rahman, Sayedur, Silveira, Md Mariângela F., Buffarini, Romina, Shapiro, Roger L., Zash, Rebecca, Zhu, Zhonghai, Zeng, Lingxia, Qiu, Xiu, He, Jianrong, Gebreyesus, Seifu H., Tesfamariam, Kokeb, Chan, Grace, Bekele, Delayehu, Adu‐Afarwuah, Seth, Dewey, Kathryn G., Gyaase, Stephaney, Wylie, Blair J., Taneja, Sunita, Chowdhury, Ranadip, Babu, Giridhara R., Deepa, R., Rishard, Mohamed, Lazzerini, Marzia, Rodriguez‐Sibaja, Maria J., Acevedo‐Gallegos, Sandra, Ashorn, Per, Maleta, Kenneth, Mullany, Luke C., Jehan, Fyezah, Ilyas, Muhammad, Rogerson, Stephen J., Unger, Holger W., Ghosh, Rakesh, Musange, Sabine, Mongkolchati, Aroonsri, Keentupthai, Paniya, Fawzi, Wafaie, Wang, Dongqing, Schmiegelow, Christentze, Minja, Daniel, Hjort, Line, Lusingu, John P. A., Smith, Emily R., Masanja, Honorati, Kabole, Fathma Mohamed, Slim, Salim Nassir, Kakuru, Abel, Kajubi, Richard, Walker, Dilys, Waiswa, Peter, Ramokolo, Vundli, Zembe‐Mkabile, Wanga, Semrau, Katherine, Hamer, Davidson H., Chico, R. Matthew, Chaponda, Enesia Banda, Manasyan, Albert, Pry, Jake M., Musokotwane, Kebby, Banda, Bowen, Prendergast, Andrew, Chasekwa, Bernard, Katz, Joanne, Lee, Anne C. C., Black, Robert E.
Format: Journal Article
Language:Inglés
Published: Wiley 2025
Subjects:
children
infants
maternal and child health
Online Access:https://hdl.handle.net/10568/177849
Summary:Objective To examine the prevalence of large‐for‐gestational age (LGA) and macrosomia in 23 countries between 2000 and 2021. Design Descriptive multi‐country secondary data analysis. Setting Subnational, population‐based cohort studies (k = 45 for LGA, k = 25 for macrosomia) in 23 low‐ and middle‐income countries (LMICs). Population Liveborn infants. Methods We conducted a secondary analysis of individual‐level data from the Vulnerable Newborn Measurement Collaboration, using INTERGROWTH‐21st standards to define LGA (> 90th centile for gestational age and sex) and macrosomia (≥ 4000 g, regardless of gestational age). We included LMIC population‐based datasets with reliable gestational age and birthweight data, excluding studies with small sample sizes, high missing data, or implausible measurements. Prevalence estimates were stratified by region, study period and gestational age, and results were summarised as medians and interquartile ranges (IQR). Main Outcome Measures Prevalence of LGA and macrosomia. Results Among 476 939 live births, the median prevalence of LGA was 5.1% (IQR: 2.9%–9.6%) and was highest in Latin America and the Caribbean at 9.6% (4 studies, IQR: 2.7%–16.1%) and lowest in South Asia at 2.7% (13 studies, IQR: 2.3%–3.7%). Over time, the median LGA prevalence increased from 4.9% (12 studies; IQR: 4.1%–7.9%) during the period from 2000 to 2010 to 5.9% (33 studies, IQR: 2.7%–11.2%) from 2011 to 2021. Term LGA was more common at 3.2% (0.9–5.1) than preterm or post‐term LGA. Among 313 064 live births, the median prevalence of macrosomia was 1.3% ( n  = 313 064, IQR: 0.2%–2.4%), which was highest in Latin America and the Caribbean (4 studies, 3.1%, IQR: 0.7%–6.8%) and lowest in South Asia (8 studies, 0.1%, IQR: 0.0%–0.7%). The median prevalence remained stable over time: 1.1% (8 studies, IQR: 0.2%–3.1%) in older studies (2000–2010) and 1.3% (17 studies, IQR: 0.5%–2.4%) in more recent studies (2011–2021). Term macrosomia was more common at 1.2% (0.2–2.0) than preterm and post‐term macrosomia. Conclusions The overall prevalence of LGA and macrosomia was lower in these LMIC studies than is reported in high‐income countries. The prevalence of large babies was highest in Latin America and the Caribbean.

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