Secular trends in neonatal macrosomia in Berlin: influences of potential determinants

To investigate the trend in the prevalence of neonatal macrosomia and to evaluate the influences of potential determinants, key features of 206 308 hospital deliveries (97% of all) in Berlin in the years 1993-99, collected by the Berlin Medical Board, were analysed using SPSS 10.0. After exclusion of multiple births and preterm infants, there was a significant increase over 7 years (P < 0.01) in the prevalence of birthweights >= 4000 g, maternal age >= 30 years, height of >= 165 cm, prepregnancy BMI (body mass index) >= 26 kg/m(2) and pregnancy weight gain > 16 kg, but no substantial trend in the prevalence of recognised diabetes or maternal smoking. The adjusted model (OR [95% Cl]) for delivering a newborn greater than or equal to 4000 g was statistically significant for post-term delivery (2.56 [2.39, 2.75]), women aged greater than or equal to 30 years (1.06 [1.02-1.11]), greater than or equal to 165 cm tall (1.94 [1.87,2.01]), multiparae (1.98 [1.91, 2.05]), not smoking in pregnancy (2.03 [1.93, 2.14]), prepregnancy BMI : 26 compared with < 20 (4.01 [3.77, 4.26]), pregnancy weight gain >= 16 kg compared with < 10 kg (3.37.[3.22, 3.53]) and for recognised diabetes (1.85.[1.69, 2.04]). It is speculated that this increase in the prevalence of neonatal macrosomia may contribute to the secular trend of overweight and obesity under affluent living conditions.