Birth - Macrosomia
|Embryology - 24 Oct 2020 Expand to Translate|
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Large gestational age (LGA) or macrosomia is a term used to describe a newborn with an excessive birth weight due to a range of known and unknown causes. There are many different definitions that have been used for to this term, generally a birth weight of 4000 to 4500 g (8 lb 13 oz to 9 lb 15 oz) or greater than 90% for gestational age after correcting for neonatal sex and ethnicity.
A recent study of USA data suggests adverse perinatal outcomes of birthweight exceeded the 97th percentile. Their definition was a "birthweight greater than 4500 g in Whites, or 4300 g in Blacks and Hispanics regardless of gestational age is the optimal threshold to define macrosomia. A birthweight greater than the 97th percentile for a given gestational age, irrespective of race is also reasonable to define macrosomia."
- Duration of gestation - growth past the due date.
- maternal diabetes - presence of gestational diabetes; and class A, B, and C diabetes mellitus.
- Genetic Syndromes and Tumours - a range of overgrowth syndromes associated with developmental delay, tumors, and other anomalies with genetic causes and syndromes (Pallister-Killian, Beckwith-Wiedemann, Sotos, Perlman, and Simpson-Golabi-Behmel) rarely diagnosed prenatally.
Currently there is clinical research looking into the best mathematical formula, based upon ultrasound measurements, to estimate the possibility of macrosomia occurring. Note that the targeted earlier delivery of fetal growth restriction (FGR) infants may remove smaller babies from later gestations, potentially causing a right-shifting the distribution of birth weights at term.
Some Recent Findings
|More recent papers|
This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.
|These papers originally appeared in the Some Recent Findings table, but as that list grew in length have now been shuffled down to this collapsible table.
Birth Weight Classification
|Birth weight (grams)||less 500||500 – 999||1,000 – 1,499||1,500 – 1,999||2,000 – 2,499||2,500 – 2,999||3,000 – 3,499||3,500 – 3,999||4,000 – 4,499||4,500 – 4,999||5,000 or more|
Birth statistics of high birth weight infants (macrosomia) in Korea.
We used 2 data sources, namely, the hospital units (1960's to 1990's) and Statistics Korea (1993 to 2010). The analyses include the incidence of high birth weight infants (HBWIs), birth weight distribution, sex ratio, and the relationship of HBWI to maternal age. The incidence of HBWIs for the past 50 years has been dropping in Korea. The older the mother, the higher was the risk of a HBWI and LBWI. We hope that these findings would be utilized as basic data that will aid those managing HBWIs.
Beckwith-Wiedemann syndrome (BWS) is an overgrowth disorder caused by either a mutation or deletion of imprinted genes within the chromosome 11p15.5 region. Infants show exomphalos, macroglossia, and gigantism and also have a predisposition to tumour development. Originally described by Beckwith and separately by Wiedemann in 1969.
- Links: OMIM 601803
Perlman congenital overgrowth syndrome is an autosomal recessive syndrome similar to Beckwith-Wiedemann syndrome (BWS; OMIM 130650). Children are large at birth, hypotonic, show organomegaly, and have a high neonatal mortality.
- Facial abnormalities - inverted V-shaped upper lip, prominent forehead, deep-set eyes, broad and flat nasal bridge, and low-set ears.
- renal abnormalities - nephromegaly and hydronephrosis.
- neural abnormalities - neurodevelopmental delay.
Loss of function of DIS3 Like 3'-5' Exoribonuclease 2 (DIS3L2 exoribonuclease) generates a mouse model of this syndrome, following up-regulation of Insulin-like growth factor 2 (Igf2). IGF2 has also been shown in other studies through microRNA miR-483-3p to contribute to macrosomia by regulating trophoblast proliferation.
- Ye J, Zhang L, Chen Y, Fang F, Luo Z & Zhang J. (2014). Searching for the definition of macrosomia through an outcome-based approach. PLoS ONE , 9, e100192. PMID: 24941024 DOI.
- Selvaratnam RJ, Davey MA & Wallace EM. (2020). The pitfalls of using birthweight centile charts to audit care. PLoS ONE , 15, e0235113. PMID: 32574213 DOI.
- Yamamoto JM, Kellett JE, Balsells M, García-Patterson A, Hadar E, Solà I, Gich I, van der Beek EM, Castañeda-Gutiérrez E, Heinonen S, Hod M, Laitinen K, Olsen SF, Poston L, Rueda R, Rust P, van Lieshout L, Schelkle B, Murphy HR & Corcoy R. (2018). Gestational Diabetes Mellitus and Diet: A Systematic Review and Meta-analysis of Randomized Controlled Trials Examining the Impact of Modified Dietary Interventions on Maternal Glucose Control and Neonatal Birth Weight. Diabetes Care , 41, 1346-1361. PMID: 29934478 DOI.
- Zeki R, Wang AY, Lui K, Li Z, Oats JJN, Homer CSE & Sullivan EA. (2018). Neonatal outcomes of live-born term singletons in vertex presentation born to mothers with diabetes during pregnancy by mode of birth: a New South Wales population-based retrospective cohort study. BMJ Paediatr Open , 2, e000224. PMID: 29637191 DOI.
- Nanda S, Akolekar R, Sarquis R, Mosconi AP & Nicolaides KH. (2011). Maternal serum adiponectin at 11 to 13 weeks of gestation in the prediction of macrosomia. Prenat. Diagn. , 31, 479-83. PMID: 21394735 DOI.
- Bennini JR, Marussi EF, Barini R, Faro C & Peralta CF. (2010). Birth-weight prediction by two- and three-dimensional ultrasound imaging. Ultrasound Obstet Gynecol , 35, 426-33. PMID: 20069666 DOI.
- Vora N & Bianchi DW. (2009). Genetic considerations in the prenatal diagnosis of overgrowth syndromes. Prenat. Diagn. , 29, 923-9. PMID: 19609940 DOI.
- Kang BH, Moon JY, Chung SH, Choi YS, Lee KS, Chang JY & Bae CW. (2012). Birth statistics of high birth weight infants (macrosomia) in Korea. Korean J Pediatr , 55, 280-5. PMID: 22977440 DOI.
- WIEDEMANN HR. (1964). [FAMILIAL MALFORMATION COMPLEX WITH UMBILICAL HERNIA AND MACROGLOSSIA--A "NEW SYNDROME"?]. J Genet Hum , 13, 223-32. PMID: 14231762
- Hunter RW, Liu Y, Manjunath H, Acharya A, Jones BT, Zhang H, Chen B, Ramalingam H, Hammer RE, Xie Y, Richardson JA, Rakheja D, Carroll TJ & Mendell JT. (2018). Loss of Dis3l2 partially phenocopies Perlman syndrome in mice and results in up-regulation of Igf2 in nephron progenitor cells. Genes Dev. , , . PMID: 29950491 DOI.
- Li J, Fu Z, Jiang H, Chen L, Wu X, Ding H, Xia Y, Wang X, Tang Q & Wu W. (2018). IGF2-derived miR-483-3p contributes to macrosomia through regulating trophoblast proliferation by targeting RB1CC1. Mol. Hum. Reprod. , , . PMID: 29939354 DOI.
De Reu PA, Smits LJ, Oosterbaan HP & Nijhuis JG. (2008). Value of a single early third trimester fetal biometry for the prediction of birth weight deviations in a low risk population. J Perinat Med , 36, 324-9. PMID: 18598122 DOI.
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- American Academy of Family Physicians Management of Suspected Fetal Macrosomia (2001)
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Cite this page: Hill, M.A. (2020, October 24) Embryology Birth - Macrosomia. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Birth_-_Macrosomia
- © Dr Mark Hill 2020, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G