How does Macrosomia affect baby's health post delivery & its causes? - Dr. Sheela B S скачать в хорошем качестве

How does Macrosomia affect baby's health post delivery & its causes? - Dr. Sheela B S

The term macrosomia is used to describe the newborn, who weighs significantly more than average. That means if the baby’s weight is more than 4000 grams, then it is called as macrosomic baby or if it is more than 90th percentile, for that period of pregnancy, then also it is called as macrosomia. So almost 10% of the babies born are macrosomic. What are the reasons or the conditions where we come across these kind of babies. Women who are obese pre pregnant can give birth to a baby who is big or women who gain excessive weight gain during pregnancy can give birth to a bigger baby. Constitutional or it can be genetic, unusually large head. Tall and heavy women can give birth to a boy baby. But most common factor or reason for this is diabetes mellitus. It can be a pre pregnant diabetes mellitus or women with Type 2 diabetes who get pregnant or GDM can have macrocosmic babies. These are the commonest conditions. Almost 60% of the women with this condition can have a macrosmic babies. Pregnancy which is prolonged, more than 41 weeks can lead to macrocosmic babies. Mother who has delivered big babies can again deliver big babies. Coming to the gender, male infants always weigh more than the female infants. What cause this kind of macrosomia in gestational diabetes pregnancies? Poor glycemic control in a woman with GDM or type 2 diabetes has always elevated glucose level in the blood. This will get transferred to the fetus. It stimulates the fetal insulin and insulin like growth factor lees which in turn stimulates the glycogen synthesis and this in turn gets deposited in the form of fat. This leads to big babies. This is the mechanism how it works in a woman with GDM. So in condition with macrosomic babies, while delivering, naturally because of the large size of the baby, of prolonged labor is there. If difficulty of labor is there, then there is a fetal distress and such babies tend to be put in the NICU for a longer time and again macrocosmic babies difficult labor, shoulder distortion are there in breech deliveries. Because of these difficult babies, there are always injury to the bones ,nerves, and also to the injury to the musculoskeletal structures. Metabolic problems are like babies can have hypoglycemia, hyperglycemia, hyperbilirubinemia, and hypercalcemia. So these are some of the complications in the fetus, in the macrosomic babies. But what are the long term problems in these babies. Babies who are born obese, they will inturn tend to develop diabetes mellitus at an earlier age, there can be again cardiac disorders, respiratory disorders and polycythemic conditions. But one important thing is girl baby who tend to be macrosomic at birth, tend to be obese adolescence and when she marries, at later age, there is a very good chance that she develops diabetes mellitus and when she delivers, she in turn deliver a macrosomic babies, which in turn become obese adolescent girl and then become a diabetic mother and develop a macrocosmic child. So this is a very vicious circle. So it becomes a social problem. So somewhere we have to deal with this very effectively in order to prevent macrosomia in pregnant woman.