- Prevalence of babies born with a birth weight of more than 4 kg is about is 10%
and this is rising. There are Increased maternal, fetal, and neonatal morbidity associated with fetal macrosomia.
- Maternal risks associated with fetal macrosomia include injury to birth canal (third-and fourth- degree perineal tears, cervical, vaginal lacerations), obstructed labour, chorioamnionitis, increased chances of Caesarean section, postpartum haemorrhage.
- Fetal risks include birth trauma (3-7%) , including shoulder dystocia, brachial plexus injury, and stillbirth
- Risk of shoulder dystocia rises from 1.5% of all virginal births to 10-25% in macrosomia.
- Neonatal risks include hypoglycaemia and electrolyte imbalances (in 50%) , early neonatal death due to asphyxia, increase in postneonatal deaths with a doubling of rate of sudden infant death syndromes compared with average-size babies.
- Long-term risks include childhood obesity and type 2 diabetes. Variations, are male six, post-dates, maternal gestational diabetes or pre-existent diabetes, maternal obesity, and excessive weight gain during pregnancy.
- Although maternal gestational diabetes and pregestational diabetes are risk factors for fetal macrosomia, the great majority of macrosomic infants are born to non- diabetic mothers.
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