Prevalence of Large-for-Gestational Age and Macrosomia Among Livebirths in 23 Low- and Middle-Income Countries Between 2000 and 2021: An Individual Participant Data Analysis
Issued Date
2025-01-01
Resource Type
ISSN
14700328
eISSN
14710528
Scopus ID
2-s2.0-105021409363
Pubmed ID
41213838
Journal Title
BJOG an International Journal of Obstetrics and Gynaecology
Rights Holder(s)
SCOPUS
Bibliographic Citation
BJOG an International Journal of Obstetrics and Gynaecology (2025)
Suggested Citation
Kirakoya-Samadoulougou F., Ukwishaka J., Ngwasiri C., Subedi S., Hazel E.A., Erchick D.J., Wu L.S.F., Grandi C., Lachat C., Toe L.C., Roberfroid D., Huybregts L., Labrique A.B., Rashid M., Shaikh S., Haque R., Baqui A.H., Saha S.K., Khanam R., Rahman S., Silveira M.M.F., Buffarini R., Shapiro R.L., Zash R., Zhu Z., Zeng L., Qiu X., He J., Gebreyesus S.H., Tesfamariam K., Chan G., Bekele D., Adu-Afarwuah S., Dewey K.G., Gyaase S., Wylie B.J., Taneja S., Chowdhury R., Babu G.R., Deepa R., Rishard M., Lazzerini M., Rodriguez-Sibaja M.J., Acevedo-Gallegos S., Ashorn P., Maleta K., Mullany L.C., Jehan F., Ilyas M., Rogerson S.J., Unger H.W., Ghosh R., Musange S., Mongkolchati A., Keentupthai P., Fawzi W., Wang D., Schmiegelow C., Minja D., Hjort L., Lusingu J.P.A., Smith E.R., Masanja H., Kabole F.M., Slim S.N., Kakuru A., Kajubi R., Walker D., Waiswa P., Ramokolo V., Zembe-Mkabile W., Semrau K., Hamer D.H., Chico R.M., Chaponda E.B., Manasyan A., Pry J.M., Musokotwane K., Banda B., Prendergast A., Chasekwa B., Katz J., Lee A.C.C., Black R.E., Ali H., Christian P., Klemm R.D.W., Massie A.B., Mitra M., Mehra S., Schulze K.J., Shamim A.A., Sommer A., Ullah B., West K.P., Begum N., Chowdhury N.H., Islam M.S., Mitra D.K., Quaiyum A. Prevalence of Large-for-Gestational Age and Macrosomia Among Livebirths in 23 Low- and Middle-Income Countries Between 2000 and 2021: An Individual Participant Data Analysis. BJOG an International Journal of Obstetrics and Gynaecology (2025). doi:10.1111/1471-0528.70044 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113125
Title
Prevalence of Large-for-Gestational Age and Macrosomia Among Livebirths in 23 Low- and Middle-Income Countries Between 2000 and 2021: An Individual Participant Data Analysis
Author(s)
Kirakoya-Samadoulougou F.
Ukwishaka J.
Ngwasiri C.
Subedi S.
Hazel E.A.
Erchick D.J.
Wu L.S.F.
Grandi C.
Lachat C.
Toe L.C.
Roberfroid D.
Huybregts L.
Labrique A.B.
Rashid M.
Shaikh S.
Haque R.
Baqui A.H.
Saha S.K.
Khanam R.
Rahman S.
Silveira M.M.F.
Buffarini R.
Shapiro R.L.
Zash R.
Zhu Z.
Zeng L.
Qiu X.
He J.
Gebreyesus S.H.
Tesfamariam K.
Chan G.
Bekele D.
Adu-Afarwuah S.
Dewey K.G.
Gyaase S.
Wylie B.J.
Taneja S.
Chowdhury R.
Babu G.R.
Deepa R.
Rishard M.
Lazzerini M.
Rodriguez-Sibaja M.J.
Acevedo-Gallegos S.
Ashorn P.
Maleta K.
Mullany L.C.
Jehan F.
Ilyas M.
Rogerson S.J.
Unger H.W.
Ghosh R.
Musange S.
Mongkolchati A.
Keentupthai P.
Fawzi W.
Wang D.
Schmiegelow C.
Minja D.
Hjort L.
Lusingu J.P.A.
Smith E.R.
Masanja H.
Kabole F.M.
Slim S.N.
Kakuru A.
Kajubi R.
Walker D.
Waiswa P.
Ramokolo V.
Zembe-Mkabile W.
Semrau K.
Hamer D.H.
Chico R.M.
Chaponda E.B.
Manasyan A.
Pry J.M.
Musokotwane K.
Banda B.
Prendergast A.
Chasekwa B.
Katz J.
Lee A.C.C.
Black R.E.
Ali H.
Christian P.
Klemm R.D.W.
Massie A.B.
Mitra M.
Mehra S.
Schulze K.J.
Shamim A.A.
Sommer A.
Ullah B.
West K.P.
Begum N.
Chowdhury N.H.
Islam M.S.
Mitra D.K.
Quaiyum A.
Ukwishaka J.
Ngwasiri C.
Subedi S.
Hazel E.A.
Erchick D.J.
Wu L.S.F.
Grandi C.
Lachat C.
Toe L.C.
Roberfroid D.
Huybregts L.
Labrique A.B.
Rashid M.
Shaikh S.
Haque R.
Baqui A.H.
Saha S.K.
Khanam R.
Rahman S.
Silveira M.M.F.
Buffarini R.
Shapiro R.L.
Zash R.
Zhu Z.
Zeng L.
Qiu X.
He J.
Gebreyesus S.H.
Tesfamariam K.
Chan G.
Bekele D.
Adu-Afarwuah S.
Dewey K.G.
Gyaase S.
Wylie B.J.
Taneja S.
Chowdhury R.
Babu G.R.
Deepa R.
Rishard M.
Lazzerini M.
Rodriguez-Sibaja M.J.
Acevedo-Gallegos S.
Ashorn P.
Maleta K.
Mullany L.C.
Jehan F.
Ilyas M.
Rogerson S.J.
Unger H.W.
Ghosh R.
Musange S.
Mongkolchati A.
Keentupthai P.
Fawzi W.
Wang D.
Schmiegelow C.
Minja D.
Hjort L.
Lusingu J.P.A.
Smith E.R.
Masanja H.
Kabole F.M.
Slim S.N.
Kakuru A.
Kajubi R.
Walker D.
Waiswa P.
Ramokolo V.
Zembe-Mkabile W.
Semrau K.
Hamer D.H.
Chico R.M.
Chaponda E.B.
Manasyan A.
Pry J.M.
Musokotwane K.
Banda B.
Prendergast A.
Chasekwa B.
Katz J.
Lee A.C.C.
Black R.E.
Ali H.
Christian P.
Klemm R.D.W.
Massie A.B.
Mitra M.
Mehra S.
Schulze K.J.
Shamim A.A.
Sommer A.
Ullah B.
West K.P.
Begum N.
Chowdhury N.H.
Islam M.S.
Mitra D.K.
Quaiyum A.
Author's Affiliation
University of California, San Francisco
University of California, Davis
Københavns Universitet
Karolinska Institutet
Brigham and Women's Hospital
Universiteit Gent
Queen Mary University of London
Beth Israel Deaconess Medical Center
Harvard T.H. Chan School of Public Health
Université Libre de Bruxelles
Johns Hopkins Bloomberg School of Public Health
London School of Hygiene & Tropical Medicine
Columbia University Irving Medical Center
Mahidol University
Boston University Chobanian & Avedisian School of Medicine
The Children's Hospital of Philadelphia
George Mason University
The Warren Alpert Medical School
UC Davis School of Medicine
Copenhagen University Hospital
North-West University
Guangzhou Medical University
Det Sundhedsvidenskabelige Fakultet
Addis Ababa University
Universidade Federal de Pelotas
University of Ghana
South African Medical Research Council
The Aga Khan University
University Hospital of Tampere
School of Public Health
Université de Namur
School of Basic Medical Sciences
University of Zambia
University of Rwanda
IRCCS Burlo Garofolo
Menzies School of Health Research
Milken Institute School of Public Health
University of Malawi
International Food Policy Research Institute
UAB Department of Pediatrics
University of Colombo Faculty of Medicine
Ubon Ratchathani University
National Institute for Medical Research Tanga
Instituto Nacional de Perinatologia
College of Medicine, Qatar University
Ifakara Health Institute
Makerere University School of Public Health
Ambo University
St. Paul‘s Hospital Millennium Medical College
Department of Infectious Diseases
Ariadne Labs
Infectious Diseases Research Collaboration
Kintampo Health Research Centre
Society for Applied Studies Kolkata
Zvitambo Institute for Maternal and Child Health Research
Child Health Research Foundation
Ministry of Health Zanzibar
Projahnmo Research Foundation
JiVitA Project
NATIONAL HIV/AIDS/STI/TB COUNCIL
PHFI Centre for Developmental and Lifecourse Research
Argentine Society of Dermatology
Noora Health
University of California, Davis
Københavns Universitet
Karolinska Institutet
Brigham and Women's Hospital
Universiteit Gent
Queen Mary University of London
Beth Israel Deaconess Medical Center
Harvard T.H. Chan School of Public Health
Université Libre de Bruxelles
Johns Hopkins Bloomberg School of Public Health
London School of Hygiene & Tropical Medicine
Columbia University Irving Medical Center
Mahidol University
Boston University Chobanian & Avedisian School of Medicine
The Children's Hospital of Philadelphia
George Mason University
The Warren Alpert Medical School
UC Davis School of Medicine
Copenhagen University Hospital
North-West University
Guangzhou Medical University
Det Sundhedsvidenskabelige Fakultet
Addis Ababa University
Universidade Federal de Pelotas
University of Ghana
South African Medical Research Council
The Aga Khan University
University Hospital of Tampere
School of Public Health
Université de Namur
School of Basic Medical Sciences
University of Zambia
University of Rwanda
IRCCS Burlo Garofolo
Menzies School of Health Research
Milken Institute School of Public Health
University of Malawi
International Food Policy Research Institute
UAB Department of Pediatrics
University of Colombo Faculty of Medicine
Ubon Ratchathani University
National Institute for Medical Research Tanga
Instituto Nacional de Perinatologia
College of Medicine, Qatar University
Ifakara Health Institute
Makerere University School of Public Health
Ambo University
St. Paul‘s Hospital Millennium Medical College
Department of Infectious Diseases
Ariadne Labs
Infectious Diseases Research Collaboration
Kintampo Health Research Centre
Society for Applied Studies Kolkata
Zvitambo Institute for Maternal and Child Health Research
Child Health Research Foundation
Ministry of Health Zanzibar
Projahnmo Research Foundation
JiVitA Project
NATIONAL HIV/AIDS/STI/TB COUNCIL
PHFI Centre for Developmental and Lifecourse Research
Argentine Society of Dermatology
Noora Health
Corresponding Author(s)
Other Contributor(s)
Abstract
Objective: To examine the prevalence of large-for-gestational age (LGA) and macrosomia in 23 countries between 2000 and 2021. Design: Descriptive multi-country secondary data analysis. Setting: Subnational, population-based cohort studies (k = 45 for LGA, k = 25 for macrosomia) in 23 low- and middle-income countries (LMICs). Population: Liveborn infants. Methods: We conducted a secondary analysis of individual-level data from the Vulnerable Newborn Measurement Collaboration, using INTERGROWTH-21st standards to define LGA (> 90th centile for gestational age and sex) and macrosomia (≥ 4000 g, regardless of gestational age). We included LMIC population-based datasets with reliable gestational age and birthweight data, excluding studies with small sample sizes, high missing data, or implausible measurements. Prevalence estimates were stratified by region, study period and gestational age, and results were summarised as medians and interquartile ranges (IQR). Main Outcome Measures: Prevalence of LGA and macrosomia. Results: Among 476 939 live births, the median prevalence of LGA was 5.1% (IQR: 2.9%–9.6%) and was highest in Latin America and the Caribbean at 9.6% (4 studies, IQR: 2.7%–16.1%) and lowest in South Asia at 2.7% (13 studies, IQR: 2.3%–3.7%). Over time, the median LGA prevalence increased from 4.9% (12 studies; IQR: 4.1%–7.9%) during the period from 2000 to 2010 to 5.9% (33 studies, IQR: 2.7%–11.2%) from 2011 to 2021. Term LGA was more common at 3.2% (0.9–5.1) than preterm or post-term LGA. Among 313 064 live births, the median prevalence of macrosomia was 1.3% (n = 313 064, IQR: 0.2%–2.4%), which was highest in Latin America and the Caribbean (4 studies, 3.1%, IQR: 0.7%–6.8%) and lowest in South Asia (8 studies, 0.1%, IQR: 0.0%–0.7%). The median prevalence remained stable over time: 1.1% (8 studies, IQR: 0.2%–3.1%) in older studies (2000–2010) and 1.3% (17 studies, IQR: 0.5%–2.4%) in more recent studies (2011–2021). Term macrosomia was more common at 1.2% (0.2–2.0) than preterm and post-term macrosomia. Conclusions: The overall prevalence of LGA and macrosomia was lower in these LMIC studies than is reported in high-income countries. The prevalence of large babies was highest in Latin America and the Caribbean.