Long-term impact of macrosomia on child body composition: findings from the ROLO Kids Study

Objectives The early fetal environment is extremely important and research indicates that weight at birth can have crucial impacts on the individual's health later in life. With the current childhood obesity epidemic, we aimed to investigate whether children born macrosomic (birthweight > 4 kg) remained larger than normal birthweight infants up to 5 years of age. Design This is a longitudinal follow up of macrosomic and normal birthweight participants born into the ROLO randomised control trial in the National Maternity Hospital, Dublin, followed up at 5 years of age. Method A total of 387 participants (53% with macrosomia, 47% normal birthweight) were followed up at 5 years of age. Birthweight was previously recorded, and at the 5 years of age, child height, weight, anthropometric, and skinfold measurements were collected. Body mass index (kg/m2) and centiles were calculated. Student's t‐tests and Mann‐Whitney U‐tests were used (Figure Presented) together with multiple linear regression to control for confounders. Results Children born macrosomic had consistently higher weights, lengths, and BMI centiles, together with increased head and chest circumferences, compared to normal birthweight children at 5 years of age (P < 0.01 for all). After controlling for child sex, intervention group, smoking during pregnancy, maternal education status, and maternal BMI, children with macrosomia were 0.61 kg heavier than nonmacrosomic infants at 5 years of age (95% CI: 0.04‐1.18, P < 0.05). Conclusions Children born macrosomic remain heavier and larger into childhood. This highlights the need for monitoring and potential interventions, both during pregnancy and in infancy, to curb the current childhood obesity crisis.