GSB 7.1 Standardlösung

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Large for gestational age

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Both diabetes occurring for the first time during pregnancy (prevalence of gestational diabetes) and diabetes existing before pregnancy (pregestational diabetes) present a risk for complications during pregnancy and birth (DDG et al. 2021; DDG, DGGG 2018). Diabetes can lead to accelerated fetal growth with subsequent increased birth weight of the newborn, which increases the risk of maternal birth injury (Farrar et al, 2016). In turn, newborns with increased birth weight show a higher risk for obesity and metabolic syndrome later in life (Zhang et al., 2023).

Key messages

  • In 2021, 10.6% of all newborns have an increased birth weight, which is within the expected range of 10% according to the indicator definition.
  • In the presence of gestational diabetes (14.5%) or pregestational diabetes (26.2%) in the mother, newborns are significantly more likely to have increased birth weight than in the absence of diabetes in the mother (10.1%).
  • Over time, the proportion of newborns with increased birth weight born to women with pregestational diabetes increases from 22.9% in 2013 to 26.2% in 2021, while this remains relatively constant for women with gestational diabetes.

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trend

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cross-section

By state

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  • By gender

    Indikatoren_ScreenreaderHinweis_Datentabelle

  • By age

    Indikatoren_ScreenreaderHinweis_Datentabelle

  • By education group

    Indikatoren_ScreenreaderHinweis_Datentabelle

Results

In 2021, 10.6% of all singletons had an increased birth weight above the 90th percentile (large for gestational age). Infants born to women with gestational diabetes (14.5%) and pregestational diabetes (26.2%) were more likely to have increased birth weight than women without diabetes (10.1%). Over time from 2013 to 2021, the proportion of newborns with increased birth weight increases for women without diabetes (2013: 9.1%; 2021: 10.1%) and women with pregestational diabetes (2013: 22.9%; 2021: 26.2%). For women with gestational diabetes, the proportion remains relatively constant (2013: 14.2%; 2021: 14.5%). With increasing maternal age, the proportion of newborns with increased birth weight increases for women without diabetes. However, among women with gestational diabetes, the proportion remains constant, and among women with pregestational diabetes, the proportion is highest in the under-25 age group.

Conclusion

The birth weight of one in ten newborns is above the 90th percentile of the weight distribution, which is in line with the expected range based on the definition of the indicator. However, the proportion of newborns with increased birth weight is higher in women with gestational diabetes and especially in women with pregestational diabetes and has also increased over time for pregestational diabetes. Increasing maternal age could explain only a small part of the increase in this regard. The high proportion of newborns with increased birth weight in women with pregestational diabetes under 25 years of age suggests that particular emphasis should be on the care of pregnant women with type 1 diabetes.

Show more information on methodology and data sources

Definition

The indicator large for gestational age is defined as the proportion of hospital-born newborns in a given year whose birth weight exceeds the 90th reference percentile based on the 2007-2011 Perinatal Survey adjusted for gestational age and sex (Voigt et al., 2014).

Reference population

All hospital-born singletons of gestational age 23rd to 43rd week of pregnancy in Germany.

Data sources

Quality assurance perinatal medicine (obstetrics) at the Institute for Quality and Transparency in Health Care (IQTIG) since 2015 based on the perinatal statistics provided by the federal states. This source provides data on all of the approximately 700,000 births that occur in German hospitals annually

Calculation

  • Observed relative values: Quotient of the number of children with LGA and the number of all children born in the hospital.
  • Age standardisation: Direct age standardization is performed using age groups <25, 25-29, 30-34, 35-39, and ≥40 years with the 2021 hospital birth population.
  • Stratification: The analysis distinguishes between women with pregestational diabetes (documented in Catalog A: "Medical History and General Findings/First Screening Examination" in the maternity log), gestational diabetes (prevalence of gestational diabetes), and no diabetes.

Data quality

The data only contains information on in-hospital birth, as the data is provided by the hospitals. Therefore, data from out-of-hospital births, which represent a very small proportion of less than 2%, are not included. As documentation of gestational diabetes in maternity logs might be incomplete, it is possible that prevalence is being underestimated. Furthermore, no distinction between type 1 and type 2 diabetes is possible in pregestational diabetes.

Referencen and external links

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