Causes and risk factors
Diabetes during gestation or history of diabetes is the most common cause of large weight in babies. Excessive weight gain in mothers and obese parents also contribute to large weight in babies. Pregnancy at an elderly age i.e. above35 years of age, polyhydraminos and placentomegaly are some of the other causes which can lead to fetal macrosomia. Excess weight of the baby is also seen in various syndromes like Weaver syndrome, Marshall-smith syndrome etc.
Clinical presentation:
The weight of the baby during birth is 4.5kg.Babies born with large weight is at high chances of suffering from low blood sugar, jaundice and respiratory distress.
Having a large weight baby does not cause development of any symptoms. However it leads to difficult labor. There are great chances of perianal tearing, damage to the coccyx and heavy blood loss. Most of the women who are expected to give birth to a large size baby deliver normally through vagina without a need of episiotomy. Although rare it can lead to shoulder dystocia where after the passage of head the baby’s shoulder gets stuck. Birth asphyxias and neonatal hypoglycemia are some of the common complications that can occur.
Investigations:
Periodic checkups during pregnancy will help the gynecologist to assess the condition. Truncal obesity and increase abdominal girth as compared to the date of pregnancy help in confirmation. Antenatal ultrasonography is helps in diagnosis.
Treatment:
Babies with large weight are delivered through Caesarian section. Timely prenatal checkup and care is must. The blood sugar levels should be kept under control. Healthy weight should be maintained during pregnancy. Baby born with large weight must be immediately feed by the mother to prevent the lowering of the blood sugar levels.
Recent update:
As per an article published in medindia, research including one of the Indian origin states that women who are obese before pregnancy and gain excess weight during pregnancy are at high risk for delivering large weight baby and hence are at greater risk for Caesarian section or trauma during delivery.
