Know the risks of giving birth to a giant baby – 02/01/2023 – Equilibrium

A woman recently gave birth to a baby who is 59 cm tall and weighs 7.3 kg.

Angerson Santos was born by caesarean section at Padre Colombo Hospital, in Parintins, Amazonas.

His weight exceeded that of the heaviest newborn ever recorded, who was born at 6.8 kg in 2016. But nowhere near the world’s heaviest baby, who was 10.2 kg when born in 1955 in Italy.

For comparison purposes, newborn boys weigh an average of 3.3 kg and girls 3.2 kg.

The term used to describe these “giant babies” is macrosomia (Greek for “big body”).

Any newborn weighing more than 4 kg, regardless of gestational age, is considered a macrosomic baby.

Macrosomic babies account for about 12% of births. In women with gestational diabetes (high blood sugar during pregnancy), this percentage increases to between 15% and 45% of births.

increased risk

Certain factors increase a woman’s risk of giving birth to a giant baby – one of them is body weight.

Obese mothers are twice as likely to have a newborn with macrosomia.

And excessive weight gain during pregnancy also increases the risk of macrosomia.

Gestational diabetes is another risk factor. Doctors at Padre Colombo Hospital attribute Angerson’s size to the fact that her mother has diabetes.

Part of this condition is due to an increase in insulin resistance in the mother during pregnancy (even in those without gestational diabetes), which increases the amount of glucose that crosses the placenta to the fetus, causing the fetus to grow excessively.

The condition also helps lipids (fats) enter the placenta, providing the baby with more “fuel” for growth.

A late pregnancy also increases the chances of having a macrosomic baby.

A maternal age greater than 35 years makes it 20% more likely that the baby will have macrosomia. The age of the father also counts. A paternal age greater than 35 years increases the risk of macrosomia by 10%.

Previous pregnancies increase the risk of macrosomia because, with each successive pregnancy, birth weight increases. Long-term pregnancies — those beyond the typical 40 weeks — also increase a baby’s risk of being macrosomic, particularly at 42 weeks and beyond.

Having a boy also increases the chance of macrosomia. Boys are three times more likely to be born macrosomic than girls.

Dangers during childbirth

Babies with macrosomia are more likely to find it difficult to move through the birth canal because of their size.

It is quite common, for example, for the baby’s shoulder to get stuck behind the mother’s pubic bone. The medical term for this is “shoulder dystocia”.

While the baby is trapped, he cannot breathe, and the umbilical cord can be compressed. It can also fracture the baby’s collarbone or damage the nerves in the brachial plexus that supply the arms – in the most severe cases, this damage can be permanent.

Shoulder dystocia happens in about 0.7% of all births, but in macrosomic babies the incidence is about 25%.

Mothers are also at greater risk for vaginal tearing during childbirth, which increases the risk of postpartum hemorrhage.

Postpartum haemorrhage is the leading cause of maternal death worldwide—and therefore, the larger the baby, the greater the risk of injury during normal vaginal delivery.

Macrosomia of newborns also leads to an increased risk of a prolongation of the second stage of labor, which occurs when the cervix is ​​fully dilated, and the baby’s head moves into the vagina.

Due to the size of macrosomic babies, this movement can be slower than normal, which can increase the risk of the mother suffering from infection, urinary retention and hematoma (internal bleeding).

One thing we don’t know about macrosomic babies is whether they stay bigger throughout life.

The limited data that exist indicate that they are more likely to be overweight or obese by age seven and are also more likely to develop type 2 diabetes later in life.

We may see more “giant” babies being born, as those born after 1970 appear to be about a pound heavier than earlier newborns.

Likewise, with increasing rates of obesity, which is a major factor in the development of macrosomia, we are likely to see more “giant” babies.

This article originally appeared on The Conversation academic news site and is republished here under a Creative Commons license. Read the original version here (in English).

This text was originally published here

Adam Taylor is Professor and Director of the Clinical Anatomy Learning Center at Lancaster University in the UK.