When bigger is not always better : Understanding 'Big Baby' or Macrosomia

During pregnancy doctor keeps a close look on baby growth. Sometime few babies can become bigger and heavier than normal .This is called as Big baby or Macrosomia, babies born with weight more than 4kg or 4.5 kg (in diabetic mother).It is a high risk obstetrics conditions with maternal and neonatal complication during labor like shoulder dystocia (shoulder stuck during vaginal birth ) , perineal tear, prolonged or obstructed labor. And fetal complication like neonatal hypoglycemia ( especially in Infant of diabetic mother) , birth injuries ( Erb’s palsy , clavicle fracture) ,polycythemia ,hypocalcemia and respiratory distress.

It is also observed that these babies have higher risk of developing metabolic syndrome later in life.

But why it is more common in infant of diabetic mother. High maternal blood glucose is taken up by fetus via placenta , this lead excessive secretion of insulin in fetus which act as a growth factor. This has a anabolic effect which results in increased fat deposition , glycogen protein synthesis mainly at trunk and shoulder.

Early identification of risk factor , regular checkup , antepartum monitoring and careful planning the delivery is must to get good outcome .

If mother nutrition and health during pregnancy decides the future of a child, should not caring for mother health should be first priority?

MBH/PS

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