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The letter raises concerns about gestational age differences across birthweight groups, the potential misuse of the term “full-term,” and an unusually high maternal infection rate without clear definitions, distinguishing GBS colonization from GBS infection. It also questions the study’s focus on GDM rather than pre-existing diabetes and clarifies rate interpretation for GDM-related macrosomia.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/minimizing-the-risk-of-macrosomia-letter-to-the-editor/436571/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/minimizing-the-risk-of-macrosomia-letter-to-the-editor/436571.png","ImageObject",300,407,{"name":92,"@type":93},"Maya Linwood","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-01","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What maternal factors were highlighted as correlated with macrosomia in the referenced article?","Question",{"text":112,"@type":113},"The letter cites gestational diabetes mellitus (GDM), 6-month gestational weight gain (6-m GWG), and maternal body mass index (BMI) as significantly correlated with macrosomia of term deliveries.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why does the letter question the “full-term” definition used in the study?",{"text":117,"@type":113},"It notes that “full-term” is defined as 390/7 to 406/7 weeks of gestational age, and argues this wording may be at higher risk of misuse.",{"name":119,"@type":110,"acceptedAnswer":120},"How does the letter address issues with the study’s definition and interpretation of infection and GBS?",{"text":121,"@type":113},"It states maternal infection appears unusually high and points out the infection may have been defined as group B streptococcus (GBS) colonization without a clear definition, emphasizing that GBS colonization differs from GBS infection.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436571,1790765130,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24},962084928432,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","J Chin MedAssoc  \nLetter to the editor  \nMinimizing the risk of macrosomia  \nSzu-Ting Yanga,b,c, Chia-Hao Liua,b,c, Peng-Hui Wanga,b,c,*  \naDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cFemale Cancer Foundation, Taipei, Taiwan, ROC  \nDEAR EDITOR,  \nWe have read the article entitled “ Association between maternal factors and fetal macrosomia in full-term singleton births” published in the latest issue of the Journal of the Chinese Medical Association with interest.1 Chen et al investigate the association between fetal macrosomia and comobilities of both mothers and newborns.1 The authors found that gestational diabetes mellitus (GDM), maternal 6-month gestational weight gain (6-m GWG), and maternal body mass index (BMI) are significantly correlated with macrosomia of term deliveries.1 We congratulated the authors’ successful publication, but some questions raised our curiosity and need clarification.  \nFirst, the mean gestational age is significantly higher in the group of macrosomia than normal birth weight (NBW) and low birth weight (LBW) (39.1 ± 0.9 vs 38.8 ± 1.0 vs 37.9 ± 0.9, p \u003C 0.001) . The difference in gestational age in the group of macrosomia, NBW, and LBW might result in the risk of bias. Previous randomized trial and population-based studies showed 39 gestational weeks is a better timing of induction, with less cesarean section rate and fewer perinatal adverse events.2 In addition, the term “full-term” used in this article may be at higher risk of misuse. Full-term stands for neonate born at 390/7 to 406/7 weeks of gestational age.3  \nSecond, the rate of maternal infection is unusually high in this cohort (33 . 8%, 29. 8%, and 37.0% in macrosomia, NBW, and LBW groups, respectively) . Previous studies reported intraamniotic infection accounts for only 2%–5% of term deliveries.4 The possible explanation is that the maternal infection is defined as group B streptococcus (GBS) colonization here, albeit without a clear definition of maternal infection in the article. However, GBS colonization, which makes up approximately a quarter of women, is different from GBS infection.5  \nThird, the authors only investigated the relationship between GDM and macrosomia, but not pre-existing DM. Women with pre-existing DM might have a fasting blood glucose level > 126mg/ dL, and 2-hours OGTT > 200mg/dL. Thus, they did not meet the criteria of GDM, and might be wrongly categorized as “normal  \n*Address correspondence. Dr. Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail addresses: phwang@vghtpe.gov.tw](ROC. E-mail addresses: phwang@vghtpe.gov.tw); [pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang).  \nConflicts of interest: Dr Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 536-537.  \nReceived January 26, 2023; accepted February 1, 2023.  \ndoi: 10. 1097/JCMA.0000000000000901.  \nCopyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \n(non-GDM) women”. Furthermore, pre-existing DM and GDM may have varied degrees of impacts on fetal overgrowth, despite inconsistent results of previous studies.6 Besides, the rates of GDM were 18.2% in neonates with macrosomia and 3.3% in those with NBW, respectively, which cannot directly translate into their description. Neonates born to mothe","cbCaivCAa5CCNHjW","https://ap.wps.com/l/cbCaivCAa5CCNHjW","pdf",287524,"English","# Letter to the editor\n## Context and referenced findings\n## Concerns about gestational age and “full-term” terminology\n## Concerns about maternal infection definition and GBS colonization\n## Questions about diabetes classification and statistical interpretation\n## Clinical implications and concluding remarks\n## Acknowledgments and references","[{\"question\":\"What maternal factors were highlighted as correlated with macrosomia in the referenced article?\",\"answer\":\"The letter cites gestational diabetes mellitus (GDM), 6-month gestational weight gain (6-m GWG), and maternal body mass index (BMI) as significantly correlated with macrosomia of term deliveries.\"},{\"question\":\"Why does the letter question the “full-term” definition used in the study?\",\"answer\":\"It notes that “full-term” is defined as 390/7 to 406/7 weeks of gestational age, and argues this wording may be at higher risk of misuse.\"},{\"question\":\"How does the letter address issues with the study’s definition and interpretation of infection and GBS?\",\"answer\":\"It states maternal infection appears unusually high and points out the infection may have been defined as group B streptococcus (GBS) colonization without a clear definition, emphasizing that GBS colonization differs from GBS infection.\"}]","Minimizing the risk of macrosomia - Letter to the editor | PDF",1790678408]