Fetal Macrosomia

Abstract

Excessive fetal growth and increased birth weight are associated with significant maternal and neonatal morbidity and have become increasingly common given the global obesity epidemic. Fetal macrosomia is traditionally defined in developed countries as fetal weight greater than 4,000 grams or 4,500 grams regardless of gestational age. Large-for-gestational-age is traditionally defined as birth weight equal to or greater than the ninetieth percentile for a given gestational age. Both are associated with a continuum of risk for complications, including shoulder dystocia, birth trauma, stillbirth, and infant mortality. Diabetes is strongly associated with macrosomia, and control of maternal hyperglycemia has been proven to decrease rates of macrosomia and associated adverse pregnancy outcomes. Pregnancy-based interventions to minimize gestational weight gain have failed to consistently demonstrate a significant impact on macrosomia. This review contains 5 tables, and 77 references. Keywords: pregnancy, macrosomia, large for gestational age, estimated fetal weight, diabetes, obesity, shoulder dystocia, cesarean delivery, stillbirth