Related articles: Great child for gestational age
Definition
A child is defined as large for gestational age when his birth weight is above the 90th percentile. This condition can lead to difficulties in performing the delivery vaginally (it increases the risk of dystocia of the shoulder, fractures of the clavicle or limbs and perinatal asphyxia), as well as hypoglycemia and fetal hyperbilirubinemia. For these reasons, caesarean section should be considered.
The main cause of a large newborn for gestational age is maternal diabetes mellitus, with poor glycemic control. In this case, macrosomia derives from the anabolic effects of high levels of fetal insulin produced in response to excessive blood glucose during pregnancy. The less the control of maternal gestational diabetes or before pregnancy, the more severe the macrosomia of the fetus will be.
In some cases, the growth of the fetus is higher than normal due to a character related to heredity or maternal conditions, such as obesity. This condition can also be had as a consequence of a protracted pregnancy. A rare cause, on the other hand, is Beckwith-Wiedemann syndrome (characterized by macrosomia, omphalocele, macroglossia and hypoglycemia).
Possible Causes * of Child large for gestational age
- Diabetes
- Gestational diabetes
- Obesity
