A study published in CMAJ (Canadian Medical Association Journal)says that high birth weight in First Nations babies are linked to a higher risk of postneonatal death or infant deaths that occur from 4 weeks to 1 year of life.
High birth weight or infant macrosomia is defined as a child being born above the 90th percentile relative to a fetal growth standard. Maternal obesity, impaired glucose tolerance and gestational diabetes can all contribute to infant macrosomia and these risks affect a greater proportion of Aboriginal populations.
This study was conducted to determine if the high incidence of macrosomia is a risk factor for perinatal and postneonatal death among First Nations in Quebec. It compared 5193 births to First Nations mothers versus 633,424 births to French mother tongue women from 1991 to 2000 in Quebec.
The authors conclude that parents and caregivers should be watchful for the potential high risk of postneonatal death among infants with macrosomia from First Nations women. Further research is needed into determining cause and effective prevention programs must be developed.
In a related commentary (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj101700.pdf, Katherine Dray-Donald, Dietetics and Human Nutrition, McGill University, writes, "despite these intriguing results concerning possible protective effects of large-for-gestational-age on infant mortality, the factors leading women to have large-for-gestational-age infants are serious for their health; pregravid obesity, weight gain during pregnancy and gestational diabetes. High birthweights in infants pose their own risks in relation to obesity as well. Good nutrition and healthy weight gains in pregnancy, food security for all, and encouraging breastfeeding and many other factors are needed to close the health disparities between infants of First Nations families and those of other Canadians."