J Korean Med Sci.  2021 Dec;36(47):e320. 10.3346/jkms.2021.36.e320.

Epidemiology of Macrosomia in Korea: Growth and Development

• Cho KH
• Yoon SJ
• Lim J
• Eun H
• Park MS
• Park KI
• Jo HS
• Lee SM

• KMID: 2523240
• DOI: http://doi.org/10.3346/jkms.2021.36.e320

Abstract

Background
Macrosomia, as an infant with birth weight over 4 kg, can have several perinatal, and neonatal complications. This study aimed to estimate the incidence of macrosomia in Korea and to identify the growth and developmental outcomes and other neonatal complications.
Methods
In total, 397,203 infants who were born in 2013 with birth weight ≥ 2.5 kg and who underwent infant health check-up between their 1 ^st and 7 ^th visit were included from the National Health Insurance Service database. The information was obtained by the International Classification of Diseases-10 codes or self-reported questionnaires in the National Health Screening Program.
Results
The distribution of infants by birth weight was as follows: 384,181 (97%) infants in the 2.5–3.99 kg (reference) group, 12,016 (3%) infants in the 4.0–4.49 kg group, 772 (0.2%) infants in the 4.5–4.99 kg group, and 78 (0.02%) infants in the ≥ 5 kg group. Macrosomia showed significantly higher incidence of sepsis, male sex, and mothers with GDM and birth injury. There was a significant difference in weight, height, and head circumference according to age, birth weight group, and combination of age and birth weight, respectively (P < 0.001). The number of infants with the weight above the 90 ^th percentile in macrosomia at each health check-up showed higher incidence than in reference group. The mean body mass index significantly differed among the groups, as 50.6 in infants with 2.5–3.99 kg of birth weight, 63.5 with 4.0–4.49 kg, 71.0 with 4.5–4.99 kg, and 73.1 with ≥ 5 kg. There was a significant difference in the incidence of poor developmental results between infants with macrosomia and the reference group at 24, 36 and 48 month of age.
Conclusion
Macrosomia was significantly associated with the risk of sepsis, birth injury, obesity and developmental problem especially in a boy born from mothers with gestational diabetes mellitus. Careful monitoring and proper strategies for monitoring growth and development are needed.

Keyword

Macrosomia; Growth and Development; Birth Weight; Infant

Figure

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  Fig. 1 The mean percentile of (A) height, (B) weight, and (C) head circumference by age at health check-up.

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  Fig. 2 Distribution trends of infants with weight above the 90th percentile by the birth weight group.

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  Fig. 3 Korean Developmental Screening Test for infants and children.

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