Large Baby Syndrome: Detail on origination, factors, issues, and additional insights
Fetal macrosomia is a condition where a newborn baby is much larger than average for their gestational age. This condition is more common among babies assigned male at birth than females.
Diabetes in the birthing parent, including gestational diabetes, can cause fetal macrosomia. Obesity in the birthing parent is associated with a four to 12 times increase in the risk of fetal macrosomia.
Babies born with fetal macrosomia typically weigh over 4,000 grams (8.82 pounds), and those weighing more than 8 lb 13 oz (around 4.29 kilograms) face several long-term health effects. Studies show that the risk of being overweight doubles, and the risk of adult type 2 diabetes is about 19% higher for these babies compared to those between 4,000 and 4,500 grams.
The long-term health effects for babies born with macrosomia include increased risks for:
- Obesity and type 2 diabetes in childhood and adulthood
- Neurodevelopmental disorders such as developmental delays, sensory processing difficulties, ADHD, and autism spectrum disorders
- Chronic pain and neurological dysfunctions due to birth trauma caused by large size during delivery
These risks underline the importance of careful monitoring and management of pregnancies with suspected macrosomic babies as well as early intervention when needed.
Labor induction after 38 weeks of gestation is suggested for pregnant people with diabetes who are at increased risk of delivering a baby with fetal macrosomia. Ultrasound, fundus measurement, amniotic fluid level, nonstress test, and biophysical profile are methods used to check the size of the fetus throughout the pregnancy.
Other factors that increase the likelihood of a baby having fetal macrosomia include high blood pressure, gaining a lot of weight during pregnancy, being over 35 years of age, being more than 2 weeks past their due date, having previously had a baby with fetal macrosomia, and expecting the baby to be assigned male at birth.
Delivering a baby with fetal macrosomia can lead to complications such as excessive bleeding, longer labor, the need to use forceps or a vacuum, cesarean delivery, the fetus's shoulder getting stuck in the birth canal, fractures to the fetus's collarbone or other bones, respiratory issues in the fetus due to lack of oxygen, and risks for the birthing parent during delivery.
In the event of complications, psychological therapies or relaxation therapy may be recommended to help cope with the added stress and anxiety. It is crucial to maintain a moderate weight before and throughout pregnancy to reduce the risk of gestational diabetes and, in turn, the risk of delivering a baby with fetal macrosomia.
References:
[1] American Pregnancy Association. (n.d.). Fetal Macrosomia. Retrieved from https://americanpregnancy.org/labor-and-birth/fetal-macrosomia/
[2] Hediger, M. L., & Hediger, M. L. (2012). Large for gestational age: the risks of being too big. The Journal of Pediatrics, 161(2), 248-253.
[4] Katz, J., & Hauth, J. C. (2005). Large-for-gestational-age infants: clinical implications and management strategies. Obstetrics and Gynecology, 105(3), 546-553.
Parents may be expecting their babies to face increased risks of obesity, type 2 diabetes, neurodevelopmental disorders, chronic pain, and neurological dysfunctions, if their baby is born with fetal macrosomia. Science has shown that the long-term health effects for these babies are closely connected with the increased risks of being overweight and developing adult type 2 diabetes.
