Development and internal validation of early- and mid-pregnancy prediction models for macrosomia in nulliparous singleton pregnancies

Purpose: Macrosomia is associated with adverse maternal and neonatal outcomes, but early risk stratification remains challenging. Most existing prediction approaches rely on later-pregnancy ultrasound measurements, limiting opportunities for earlier preventive counseling and monitoring. Methods: In this secondary analysis of the prospective nuMoM2b cohort in the United States, we included 6,371 nulliparous singleton pregnancies selected for available periconceptional diet and ultrasound data at Visits 2 and 3. We developed visit-updated multivariable logistic regression models for birthweight

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