Epidemiology

Maternal waist to hip ratio is a risk factor for macrosomia

  1. W Salem1,2,
  2. AI Adler3,
  3. C Lee4,
  4. GCS Smith5,6

Article first published online: 18 OCT 2011

DOI: 10.1111/j.1471-0528.2011.03167.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 119, Issue 3, pages 291–297, February 2012

Additional Information

How to Cite

Salem, W., Adler, A., Lee, C. and Smith, G. (2012), Maternal waist to hip ratio is a risk factor for macrosomia. BJOG: An International Journal of Obstetrics & Gynaecology, 119: 291–297. doi: 10.1111/j.1471-0528.2011.03167.x

Author Information

  1. 1

    Mayo Clinic College of Medicine, Rochester, Minnesota, USA

  2. 2

    Institute of Public Health, Cambridge University, Cambridge, UK

  3. 3

    Amanda I. Adler Institute of Metabolic Sciences

  4. 4

    Christine Lee Institute of Metabolic Sciences, Addenbrooke’s Hospital, Cambridge, UK

  5. 5

    Department of Obstetrics and Gynaecology, Cambridge University, Cambridge, UK

  6. 6

    NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK

*Prof GCS Smith, Department of Obstetrics and Gynaecology, Cambridge University, Rosie Maternity Hospital, Cambridge, CB2 2SW, UK. Email gcss2@cam.ac.uk

Publication History

  1. Issue published online: 12 JAN 2012
  2. Article first published online: 18 OCT 2011
  3. Accepted 24 August 2011. Published Online 18 October 2011.

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Keywords:

  • Avon Longitudinal Study of Parents and Children;
  • hip;
  • macrosomia;
  • obesity;
  • sensitivity;
  • specificity;
  • waist

Please cite this paper as: Salem W, Adler A, Lee C, Smith G. Maternal waist to hip ratio is a risk factor for macrosomia. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03167.x.

Objective  Fetal growth during pregnancy may be affected by the metabolic activity and distribution of fat stores in women. This study investigates the association between waist to hip ratio (WHR) as a measure of the distribution of adiposity in primiparous mothers living in Avon, England, and macrosomia in their offspring.

Design  Prospective historical cohort study.

Setting  The Avon Longitudinal Study of Parents and Children (ALSPAC) prospective cohort study in Avon, UK.

Population  A cohort of 3083 primiparous women with a term singleton delivery with expected dates of delivery from 1 April 1991 to 31 December 1992.

Methods  The distribution of WHR was categorised into quartiles. We compared the second, third and fourth quartiles against the first (reference) quartile with respect to whether the mother delivered a macrosomic newborn. We controlled for maternal age, gestational age, body mass index (BMI), marital status and racial group using multivariate logistic regression.

Main outcome measures  Macrosomia defined in three ways: birthweight ≥ 4000 g; birthweight ≥ 4500 g; large for gestational age (LGA: ≥ 95th percentile of birth weight adjusted for sex and gestational age).

Results  Waist to hip ratios in the third and fourth quartiles were associated with a higher odds of delivering a macrosomic infant, defined as a birthweight ≥ 4000 g (third quartile, OR 1.59, 95% CI 1.12–2.26; fourth quartile, OR 1.69, 95% CI 1.18–2.42) or as LGA (≥95th percentile of the cohort; third quartile, OR 1.77, 95% CI 1.10–2.85; fourth quartile, OR 1.78, 95% CI 1.09–2.91). When defined as a birthweight ≥ 4500 g, the fourth quartile was associated with increased odds of macrosomia (OR 2.74, 95% CI 1.05–7.16). Odds ratios after adjustment for confounding factors followed a similar pattern.

Conclusion  Independent of confounding factors, women with increased WHRs were significantly more likely to give birth to macrosomic newborns.

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