73 - Adverse Neonatal Outcomes of Large for Gestational Age Neonates in a Predominantly African- and Caribbean-American Inner-City Population
Monday, May 1, 2023
9:30 AM – 11:30 AM ET
Poster Number: 73 Publication Number: 73.429
Pavani Chitamanni, State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, United States; Kahmun Lo, SUNY Downstate, New York, NY, United States; Molly A. Schneider, SUNY Downstate Health Sciences University, Brooklyn, NY, United States; Lawrence Fordjour, State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, United States
Resident Physician State University of New York Downstate Medical Center College of Medicine Brooklyn, New York, United States
Background: The prevalence of obesity in adults and children continues to rise. The prevalence of obesity in adults and children continues to rise. Nationally, 41.9 % of adults are obese, with highest level observed in African American population - 49.9%. In addition, obesity rates for African American kids increased from 19.5% to 23.8% in the last decade. Large for Gestational Age (LGA) births are associated with increased risk for perinatal morbidity as well as potential long-term childhood complications. Objective: To study the maternal, perinatal and neonatal factors associated with LGA term births in an African- and Caribbean-American inner-city population and to assess risk factors and outcomes associated with LGA babies. Design/Methods: We performed a retrospective chart review of term LGA and AGA babies born at SUNY Downstate University Hospital of Brooklyn between 2018 and 2021. LGA was categorized into 3 groups as 90th- 95th, 95th - 97th and >97th Birthweight (BW) percentiles. BW centiles were corrected for infant sex and gestational age using the interactive web application z-score calculator (Aris et al). Maternal Body Mass Index (BMI) was categorized as normal (20-25), overweight (25-30), obese (30-40) or morbidly obese ( >40). Neonatal, maternal and peripartum outcomes were identified and analyzed using one-way ANOVA and Chi square tests. Results: The total number of live births included was 3991, of which 2.95 % were LGA. Among LGA babies, median maternal age was 30 years, median parity was 1. About 76% were single mothers and 88% were African American women. The median weight gain in the last 2 trimesters was15.39 kg, the median BMI was 36.16. Over 99% of LGA neonates were born to mothers with BMI > 25 and 88.5% of mothers had excessive pregnancy weight gain (Table 1). Pregnancy complications included gestational diabetes mellitus (11%), preeclampsia (4.2%) and C-section rate was 60%, as compared to 30% in AGA babies. The male: female ratio was 63:37, the median gestational age was 39 weeks (37-42weeks) and median BW was 4178 g among LGA babies. Significant neonatal morbidities included respiratory distress (21.2%), hypoglycemia (7.6%), jaundice (10.2%) and shoulder dystocia (2.5%). Babies with BW above 97% had higher C-section rate, incidence of hypoglycemia requiring IV fluids and increased hospital length of stay.
Conclusion(s): This study suggests that LGA babies have higher risk of complications, especially with BW above 97%.Increased neonatal, maternal and perinatal complications necessitate further evaluation of antenatal and pregnancy factors in order to improve care for this community.
