Macrosomic newborn with diabetic fetopathy. Photo courtesy of Ute M. Schäfer-Graf: Management of pregnancies with gestational diabetes based solely on maternal glycemia versus glycemia plus fetal growth.

First Nation Babies' High Birth Weight Linked to Postneonatal Death

ICTMN Staff
1/17/11

High birth weights in First Nations babies may indicate an increased risk of postneonatal death, according to a study published in the Canadian Medical Association Journal, reports the association’s press release.

Postneonatal death refers to infant deaths within four weeks to one year of age. The recent CMAJ study links such incidents to infant macrosomia, or high birth weight classified as a child born above the 90th percentile relative to a fetal growth standard. Infant macrosomia is often triggered by “maternal obesity, impaired glucose tolerance and gestational diabetes”—all risk factors among Aboriginal populations.

This study investigated the high incidence of macrosomia among First Nations in Quebec, attempting to determine its correlation between perinatal and postneonatal death. The study “compared 5,193 births to First Nations mothers versus 633,424 births to French mother tongue women from 1991 to 2000 in Quebec,” stated the press release.

"We found that macrosomia was not associated with increased risk of perinatal death among births to First Nations women, although its [macrosomia's] prevalence was three times higher than among births to women whose mother tongue women is French," writes Dr. Zhong-Cheng Luo, of the University of Montreal's Department of Obstetrics and Gynecology and Sainte-Justine University Hospital Centre in Montreal, Quebec, with coauthors. "Unexpectedly, macrosomia was associated with a much greater risk of postneonatal death (8.3 times as high) among infants of First Nations versus French mother tongue women."

The study sheds light on the need for doctors and parents to pay close attention to the potential high risk of postneonatal death among infants with macrosomia born to First Nations women. The next step: establishing prevention programs, which authors say will require more research.

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