Large for gestational age
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Large for gestational age Classification and external resources | |
| LGA: A healthy 11-pound newborn boy, delivered vaginally without complications (41 weeks; fourth child; no GD) | |
| ICD-10 | P08. |
| ICD-9 | 766 |
| DiseasesDB | 21929 |
| MedlinePlus | 002251 |
| eMedicine | med/3279 |
| MeSH | D005320 |
Large for gestational age (LGA) babies are those whose birth weight lies above the 90th percentile for that gestational age. Macrosomia, also known as big baby syndrome, is sometimes used synonymously with LGA, or is otherwise defined as a fetus that weighs above 4000 grams (8 lb 13 oz) or 4500 grams (9 lb 15 oz) regardless of gestational age.
Contents |
Diagnosis
LGA is generally not diagnosed until after the birth, as the size and weight of the child is rarely checked during the latter stages of pregnancy. Babies that are large for gestational age throughout the pregnancy can sometimes be seen during a routine ultrasound, although fetal weight estimations late in pregnancy are quite imprecise.[1]
There are believed to be links with polyhydramnios (excessive amniotic sac fluid).
Predetermining factors
One of the primary risk factors is poorly-controlled diabetes, particularly gestational diabetes (GD), as well as preexistent diabetes mellitus (DM). This increases maternal plasma glucose levels as well as insulin, stimulating fetal growth. The LGA newborn exposed to maternal DM usually has an increase only in weight. LGA newborns that have complications other than exposure to maternal DM present with universal measurements >90th percentile.
Other indicating factors include:
- Gestational age; pregnancies that go beyond 40 weeks increase incidence
- Fetal sex; male infants tend to weigh more than female infants
- Genetic factors; taller, heavier parents tend to have larger babies, with an obese mother greatly increasing the chances
- Excessive maternal weight gain
- Multiparity (have 2-3x the number of LGA infants vs. primaparas)
- Congenital anomalies (transposition of great vessels)
- Erythroblastosis fetalis
- Use of some antibiotics (amoxicillin, pivampicillin) during pregnancy
The condition is most common in mothers of African origin, partly due to the higher incidence of diabetes.
Treatment
Depending upon the relative size of the head of the baby and the pelvic diameter of the mother vaginal birth may become complicated. One of the most common complications is shoulder dystocia. Such pregnancies often end in caesarean sections in order to safely deliver the baby and to avoid birth canal lacerations. Upon birth, early feeding is essential to prevent fetal hypoglycemia. Early diagnosis of individual problems is required.
References
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
