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Please cite this paper as: Bao C, Zhou Y, Jiang L, Sun C, Wang F, Xia W, Han F, Zhao Y, Wu L. Reasons for the increasing incidence of macrosomia in Harbin, China. BJOG 2011;118:93-98. A population-based retrospective study was conducted in Harbin, China. The medical records of 13 711 singleton infants born between 2001 and 2005 in 16 hospitals were reviewed. The incidence of macrosomia (birthweight ≥4000 g) was found to have increased from 8.31% in 2001 to 10.50% in 2005. Over this period, the ponderal index decreased and birth length increased in infants with macrosomia. In a multivariate analysis, risk factors for delivery of a newborn with macrosomia were found to be high prepartal body mass index (BMI), maternal height ≥165 cm, male gender of the newborn, gestational age of 40-41.9 weeks, maternal age ≥30 years and a maternal diagnosis of hypertension. The increase in the incidence of macrosomia in Harbin was attributable to increases in maternal prepartal BMI, height and age in the population. [ABSTRACT FROM AUTHOR]