A Follow-up Study On Physical Development And Blood Pressure Of Fetal Macrosomia From Birth To 4 Years Old

Objective To assess the physical development and blood pressure status of fetal macrosomia from birth to 4 years old and to explore the differences in genders, ages, and different categories of fetal macrosomia in order to reveal the characteristic and regularity in them.Methods Macrosomic infants with birth weight = or > 4000g were come from newborn information of three women and children health stations in Hefei city from January 2004 to December 2006. Follow-up visit were done in every women and children health station after telephone subscription from August to November in 2008. 211 children with fetal macrosomia were investigated which included 39 children with birth weight = or > 4500g. 26 mothers of fetal macrosomia had gestational glycometabolism abnormality which included 3 with gestational diabetes mellitus and 23 with gestational impaired glucose tolerance. Meanwhile, the control group was matched by birth time and region in the parade. Antenatal care handbook and self-made questionnaire were used to collect gestation information, demographic characteristics, feeding patterns, food and drink behaviors. Body length, weight and head circumference were recorded old from childcare handbook in 0-2 years old. Body length/height, weight, sitting height, head circumference, chest circumference, and arm circumference were measured to evaluate physical development status. Children's blood pressure was measured by desktop mercurial sphygmomanometer. Meanwhile, mothers' physical indexes and blood pressure were measured. Analysis of the born basic conditions in the fetal macrosomia and control groups used t test and Chi-square test. LMS was used to establish standard percentile curve of physical growth indexes. Comparison of indexes of physical development and blood pressure between the fetal macrosomia and control groups used the paired Student t test and the paired Chi-square test. ANOVA was used to compare mothers' blood pressure in different groups. The relation between children's blood pressure and mothers' blood pressure was used Partial Correlation. The factors affecting children's blood pressure were used Multiple Linear Regression Analysis.Results There had no significant difference in weight, body length, head circumference, and chest circumference at birth between male and female of fetal macrosomia. Birth weight of fetal macrosomia with gestational glycometabolism abnormality in their mothers was higher than that of normal group, but there had no significant difference in body length, head circumference, and chest circumference at birth between them. There had no significant difference in feeding patterns, food and drink behavior between fetal macrosomia and control groups.Weight and body length of fetal macrosomia group were higher than that of control group in 0-2 years old, but the difference was not increased along with age. The difference of head circumference was diminished along with age between the two groups. Weight, body length/height, BMI, arm circumference, head circumference and chest circumference of fetal macrosomia group were higher than that of control group at follow-up period. The grades of physical development among length/height-for-age, weight-for-age, and weight-for-length/height in fetal macrosomia group had a higher level than that of control group too. Subscapularis and ventral skinfold thickness in fetal macrosomia group were higher than control group, but there had no significant difference in deltoideus skinfold thickness between them. The differences were more obviously in male than female, above 3 years old than below 3 years old when fetal macrosomia group was compared to control group. The differences were more obviously in birth weight among 4000-4500g than birth weight = or >4500g about indexes of physical growth, but it was opposite in skinfold thickness. There had no significant difference in indexes of physical development and skinfold thickness between children of fetal macrosomia with gestational glycometabolism abnormality in their mothers and control group. But all indexes of physical development, subscapularis and ventral skinfold thickness among fetal macrosomia group with gestational glycometabolism normal in their mothers were higher than that of control group.Diastolic blood pressure in fetal macrosomia group was higher than that in control group, but there had no significant difference in systolic blood pressure between them. The phenomenon was existed in male or female, different age groups, super fetal macrosomia or not. But both diastolic blood pressure and systolic blood pressure had no significant difference between fetal macrosomia group with gestational glycometabolism abnormality in their mothers and control group. Mothers' blood pressure of different category fetal macrosomia was higher than that of control group. The correlation of blood pressure between normal birth weight children and their mother were tighter than that between children with fetal macrosomia and their mothers. Factors affecting children's systolic blood pressure had gender, ages, present BMI of themselves and mother's systolic blood pressure. Factors affecting children's diastolic blood pressure had birth weight, ages, present BMI of themselves and mother's diastolic blood pressure.Conclusions Children with fetal macrosomia were superior in physical development compared to children with normal birth weight in 0-4 years old, but they had lipophilia. It was different in genders, ages, super fetal macrosomia or not. Children with fetal macrosomia had higher diastolic blood pressure than children with normal birth weight. But with regard to children of fetal macrosomia with gestational glycometabolism normal in their mothers, there had no difference in physical development and blood pressure compared to children with normal birth weight.