Do infants with major congenital anomalies have an excess of macrosomia?

• Published in: Teratology (Philadelphia) Vol. 64; no. 6; pp. 311 - 317
• Main Authors: Waller, D.K., Keddie, A.M., Canfield, M.A., Scheuerle, A.E.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York John Wiley & Sons, Inc 01-12-2001; Wiley-Liss
• Subjects: Abnormalities, Multiple - diagnosis; Abnormalities, Multiple - etiology; Biological and medical sciences; Birth Weight; Case-Control Studies; Embryology: invertebrates and vertebrates. Teratology; Female; Fetal Macrosomia - complications; Fundamental and applied biological sciences. Psychology; Humans; Male; Models, Statistical; Odds Ratio; Teratology. Teratogens; United States; North America; Texas; America; Human; Fetal diseases; Concomitant disease; Newborn; Pregnancy disorders; Congenital; Malformation; Case control study; Epidemiology; Macrosomia
• ISSN: 0040-3709; 1096-9926
• DOI: 10.1002/tera.1086

Background
Infants that develop congenital anomalies may also have an excess prevalence of macrosomia (birth weight ≥4,000 g). This may indicate that abnormalities of glycemic control play a role in the etiology of birth defects. This study was undertaken to determine whether all infants with congenital anomalies have an excess of macrosomia and whether it is confined to specific types of anomalies.
Methods
A case‐control study was conducted, comparing the birth weights of 8,226 infants with congenital anomalies ascertained by the Texas Birth Defects Monitoring Division with those of 965,965 infants without birth defects. Odds ratios were calculated to determine the association between birth weight and congenital anomalies, for 45 specific defects, and for all these defects combined.
Results
For all 45 defects combined, a significant association occurred only in the highest birth weight category. Infants with congenital anomalies were more likely than infants without birth defects to have a birth weight ≥4,500 g (OR = 1.65; 95% CI = 1.39–1.96). Infants born with ventricular septal defects, atrial septal defects, ventricular hypertrophy, or anomalies of the great vessels were 1.5–2.5 times more likely to weigh ≥4,000 g than were infants without birth defects. Based on small numbers, a stronger excess of macrosomia was observed for infants with encephalocele, holoprosencephaly, anomalies of the corpus callosum, preaxial polydactyly, and omphalocele.
Conclusions
Our data suggest that infants with specific congenital anomalies are more likely to be macrosomic than are infants without an anomaly. If these findings are confirmed, associations between macrosomia and specific types of birth defects may help to identify birth defects that are caused by alterations in glycemic control. Teratology 64:311–317, 2001. © 2001 Wiley‐Liss, Inc.