Search

Researchers propose three grades of fetal macrosomia, based on data from the National Center for Health Statistics between 1995 and 1997. Grade 1 includes any newborn baby who weighs more than 4,000 grams, grade 2 any baby who weighs more than 4,500 grams, and grade 3 any baby who weighs more than 5,000 grams. Grades 2 and 3 have a higher risk of adverse birth outcomes than grade 1. Macrosomia means the baby is bigger than normal.

Pregnant women who were overweight or obese before pregnancy have a higher risk of gestational diabetes, larger than normal babies, and cesarean delivery. The number of Americans who are obese has increased since 1980.

Pregnant women who have elevated blood sugar have a greater risk of cesarean delivery and fetal macrosomia even if their blood sugar is not abnormally high, according to a study of 4,773 women. Fetal macrosomia means the baby is much bigger than normal at birth.

Elevated blood levels of glycosylated hemoglobin during the first trimester of pregnancy can predict which babies will be larger than normal. In a study of 120 women with diabetes, glycosylated hemoglobin levels were higher throughout pregnancy in the mothers who gave birth to larger than normal babies.

Unrecognized gestational diabetes can lead to difficult labor, infants that are large for their age and birth trauma. Gestational diabetes is diabetes that begins during pregnancy. Researchers compared birth outcomes in 472 women with gestational diabetes, including 16 who were not diagnosed until after their pregnancy. These 16 women were more likely to have large for gestational age infants, difficult labor and birth trauma. This was true even in those who were not overweight to begin with.

Grand multiparity may not confer risk aside from the risks incurred from increasing age. Labor complication rates believed to associate with grand multiparity were compared between a group of 382 women having a fifth baby or more and 382 age-matched women having a second, third, or fourth baby. Rates of placental abruption (the detachment of some or all of the placenta from the uterus before birth), dysfunctional labor, breech or other fetal malpresentation, postpartum hemorrhage, and shoulder dystocia (difficulty birthing the shoulder) were similar between the two groups. The overall incidence of labor complications was 33% among grand multiparas and 27% among the control population. Grand multiparas were more likely to have infants with birth weight of 4000 g or more and less likely to have forceps, vacuum extraction, or cesarean delivery. A large baby increased the risk of labor complications, but this was a confounding factor and was not related to prior number of births.

Analysis of 109 consecutive pregnancies in type 1 diabetic women cared for in a single center over a 5 year period allowed identification of predictors of macrosomia and of neonatal [...]

Postprandial glucose (PPG) has been reported to be the most important predictor of macrosomia. Therefore, standard blood glucose monitoring (SBGM) protocols, performed by fingersticks, are timed to observe the peak [...]