Birth - Macrosomia: Difference between revisions

From Embryology
No edit summary
Line 23: Line 23:
|}
|}


{{Birth-Weights Table}}
{{Birth-Weight Table}}


==References==
==References==

Revision as of 12:55, 26 February 2012

Introduction

Historic model of birth

Macrosomia (large gestational age, LGA) is a term used to describe a newborn with an excessive birth weight due to a range of known and unknown causes. The definition is either 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.

  1. Duration of gestation - growth past the due date.
  2. Maternal diabetes - presence of gestational diabetes; and class A, B, and C diabetes mellitus.
  3. 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.


Birth Links: birth | Lecture - Birth | caesarean | preterm birth | birth weight | macrosomia | Birth Statistics | Australian Birth Data | Developmental Origins of Health and Disease (DOHAD) | Neonatal Diagnosis | Apgar test | Guthrie test | neonatal | stillbirth and perinatal death | ICD-10 Perinatal Period | Category:Birth
Historic Birth links  
1921 USA Birth Mortality

| Maternal Diabetes

Some Recent Findings

  • Maternal serum adiponectin at 11 to 13 weeks of gestation in the prediction of macrosomia[1] "Maternal serum adiponectin concentration was measured in a case-control study of singleton pregnancies at 11 to 13 weeks' gestation, which included 50 cases that subsequently delivered macrosomic neonates with birth weight above the 95th percentile for gestation at delivery and 300 controls who delivered appropriate for gestational age neonates. In the macrosomic group the median serum adiponectin [0.82, interquartile range (IQR): 0.56-1.02 MoM] was significantly lower than in the non-macrosomic controls (1.02, IQR: 0.70-1.29 MoM; p = 0.001). The estimated detection rate of macrosomia, at fixed false positive rate of 10%, from maternal characteristics and obstetric history was 34.6% and this increased to 38.2% with the addition of serum adiponectin. Maternal serum adiponectin at 11 to 13 weeks is a useful biomarker for early prediction of macrosomia."
  • Birth-weight prediction by two- and three-dimensional ultrasound imaging[2] "To compare the accuracies of birth-weight predicting models derived from two-dimensional (2D) ultrasound parameters and from total fetal thigh volumes measured by three-dimensional (3D) ultrasound imaging; and to compare the performances of these formulae with those of previously published equations. ...We believe that the greatest sources of discrepancy in estimation of birth weight are the phenotypic differences among patients used to create each of the formulae mentioned in this study. Our data reinforce the need for customized birth-weight prediction formulae, regardless of whether 2D or 3D measurements are employed."
  • Genetic considerations in the prenatal diagnosis of overgrowth syndromes[3] "Large (>90%) for gestational age (LGA) fetuses are usually identified incidentally. Detection of the LGA fetus should first prompt the provider to rule out incorrect dates and maternal diabetes. Once this is done, consideration should be given to certain overgrowth syndromes, especially if anomalies are present. The overgrowth syndromes have significant clinical and molecular overlap, and are associated with developmental delay, tumors, and other anomalies. Although genetic causes of overgrowth are considered postnatally, they are infrequently diagnosed prenatally. Here, we review prenatal sonographic findings in fetal overgrowth syndromes, including Pallister-Killian, Beckwith-Wiedemann, Sotos, Perlman, and Simpson-Golabi-Behmel. We also discuss prenatal diagnosis options and recurrence risks."
Human Birth Weight Classifications
no colour
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
Classification
Extremely Low Birth Weight
Very Low Birth Weight
Low Birth Weight
Normal Birth Weight
High Birth Weight

References

  1. <pubmed>21394735</pubmed>
  2. <pubmed>20069666</pubmed>
  3. <pubmed>19609940</pubmed>

Reviews

Articles

<pubmed>18598122</pubmed>

Search Pubmed

Search Pubmed: Macrosomia | high birth weight

External Links

External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.

Glossary Links

Glossary: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Numbers | Symbols | Term Link