title: Central adiposity and other anthropometric factors in relation to risk of macrosomia in an African American population.
abstract: OBJECTIVE
  Previous studies have consistently identified maternal obesity and gestational weight gain (GWG) as risk factors for macrosomia, but little is known about the effects of central adiposity and body fat distribution. Using self-reported data from the Black Women's Health Study (BWHS), a large follow-up study of US black women, we examined the risk of macrosomia in relation to prepregnancy waist circumference, prepregnancy waist-to-hip ratio (WHR), prepregnancy BMI, and GWG.
  
  
  METHODS
  During 1995-2003, BWHS participants ages 21-44 years delivered 6,687 full-term singleton births (gestational age >37 weeks). We compared mothers of 691 infants weighing ≥ 4,000 g with mothers of 5,996 infants weighing <4,000 g. Generalized estimating equation models (GEE) that accounted for more than one birth per mother were used to estimate multivariable odds ratios (OR) and 95% confidence intervals (CI).
  
  
  RESULTS
  Independent of prepregnancy BMI, prepregnancy waist circumference was positively associated with risk of macrosomia (OR = 1.58, 95% CI: 1.07-2.32, for ≥ 35.0 vs. <27.0 inches (≥ 88.9 vs. <68.6 cm); P trend = 0.04). As expected, prepregnancy BMI was also positively associated with macrosomia (OR = 1.74, 95% CI: 1.25-2.41 for BMI ≥ 35.0 vs. 18.5-24.9 kg m(-2)). GWG above the amount recommended by the 2009 Institute of Medicine report was associated with an increased risk of macrosomia and the association was present in each category of prepregnancy BMI (18.5-24.9, 25.0-29.9, and ≥ 30.0 kg m(-2); P trend <0.001).
  
  
  CONCLUSIONS
  Our data suggest that overall obesity, high GWG, and high waist circumference are independent risk factors for macrosomia among US black women.
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, Massachusetts, USA.
authors.forename: Se
authors.initials: S
authors.lastname: Li
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.forename: Ghasi S
authors.initials: GS
authors.lastname: Phillips
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Heffner
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Wise
mesh_terms: D000328:Adult; D001741:Black or African American; D000886:Anthropometry; D001724:Birth Weight; D015992:Body Mass Index; D016001:Confidence Intervals; D005260:Female; D005320:Fetal Macrosomia / Q000208:ethnology / Q000209:etiology*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000208:ethnology; D056128:Obesity, Abdominal / Q000150:complications* / Q000208:ethnology; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D015430:Weight Gain