{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:27:21Z","timestamp":1787243241108,"version":"build-2736575974"},"reference-count":36,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0247_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the effect of interaction between parity, overweight\/obesity, gestational weight gain, and gestational diabetes mellitus (GDM) on the incidence of fetal macrosomia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0247_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a population-based dataset to establish the incidence of macrosomia (birth weight &gt;4,000 g) in singleton births at \u226538 weeks\u2019 gestation. The cohort included women who were (1) overweight\/obese or had normal body mass index (BMI) before pregnancy, (2) nulliparous or multiparous, (3) with appropriate or excessive weight gain, and (4) without GDM, with GDM controlled by nonpharmacological treatment (GDM0), or with GDM requiring insulin treatment (GDM1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0247_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We examined 129,686 births at\u00a0\u226538\u00a0weeks. The mean gestational age at birth for all subgroup was similar. When compared with a reference incidence for nulliparas with normal pregravid BMI, appropriate weight gain, and without GDM, all variables, except GDM, independently and significantly increased the incidence of neonates weighing &gt;4,000 g. The logistic regression analysis found that excessive weight gain, pregravid BMI &gt;25, and parity were the only independent factors associate with birth weight &gt;4,000\u00a0g.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0247_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Well-managed GDM is not significantly associated with macrosomia, whereas pre-pregnancy obesity, excessive gestational weight gain, and parity appear to be significant risk factors. These results emphasize the need for effective weight management before and during pregnancy to reduce the risk of fetal overgrowth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0247","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T22:30:22Z","timestamp":1758234622000},"page":"129-138","source":"Crossref","is-referenced-by-count":3,"title":["Gestational diabetes and fetal macrosomia: a dissenting opinion"],"prefix":"10.1515","volume":"54","author":[{"given":"Renata","family":"Ko\u0161ir Poga\u010dnik","sequence":"first","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Centre Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Krajec","sequence":"additional","affiliation":[{"name":"Department of Gynecological Oncology , Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Batkoska","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Centre Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreja","family":"Trojner Bregar","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Centre Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"2026053007194308216_j_jpm-2025-0247_ref_001","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Practice Bulletins\u2014Obstetrics. 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