High Birthweight

High birthweight (HBW), or macrosomia (large body), in an infant also increases the risk to the infant and mother. A widely agreed upon definition of macrosomia has yet to be established but often-used definitions include a birthweight equal to or exceeding 4,000 grams (8 pounds, 12 ounces), 4,250 grams (9 pounds, 4 ounces), or 4,500 grams (9 pounds, 14 ounces), as well as a birth weighing at or above the ninetieth percentile of birthweights for the infant's gestational age. While one-third of macrosomic births are still unexplained, several factors are known to contribute to excessive fetal size, including large size of parents (especially the mother), multiparity diabetes in the mother, and prolonged gestation. Older maternal age, male infants, and previous delivery of a high birthweight infant also seem to be indicative of macrosomic births. Babies of diabetic women are usually large at birth, but they behave clinically as if they are immature. These infants are not longer in average length but have increased fetal weight. Because glucose, a substance necessary for fetal growth, is elevated in both diabetic and obese women, these mothers are more likely to have macrosomic births.

Risks for birth injuries rise rapidly for heavier babies, with vaginal deliveries being related to higher morbidity and mortality for both the infant and the mother. Lacerations of the birth canal and hemor-rhaging may occur to the mother, fetal death may occur due to asphyxia (lack of oxygen), and infants may suffer broken clavicles and neurological damage. While cesarean delivery has been prescribed as the best delivery method to prevent fetal death or injury, others suggest that vaginal birth is still possible for some macrosomic infants.

See also: INFANT MORTALITY; PREMATURE INFANTS Bibliography

Alexander, Greg. "Preterm Birth: Etiologies, Mechanisms, and Prevention." Prenatal and Neonatal Medicine 3, no. 1

Alexander, Greg, and Carol Korenbrot. "The Role of Prenatal Care in Preventing Low Birth Weight.'' Future of Children 5, no. 1 (1995):103-120. Alexander, Greg, John Himes, Rajni Kaufman, Joanne Mor, and Michael Kogan. "A U.S. National Reference for Fetal Growth.'' Obstetrics and Gynecology 87, no. 2 (1996):163—168. Alexander, Greg, Mark Tompkins, Marilee Allen, and Thomas Hulsey. ''Trends and Racial Differences in Birth Weight and Related Survival.'' Maternal and Child Health Journal 3, no. 1

Alexander, Greg, and Michael Kogan. ''Ethnic Differences in Birth Outcomes: The Search for Answers Continues.'' Birth 23, no. 3 (1998):210-213.

Alexander, Greg, Michael Kogan, John Himes, Joanne Mor, and Robert Goldenberg. "Racial Differences in Birth Weight for Gestational Age and Infant Mortality in Extremely-Low-Risk U.S. Populations.'' Paediatric and Perinatal Epidemiology 13 (1999):205-217.

Alexander, Greg, Michael Kogan, Joyce Martin, and Emile Papi-ernik. ''What Are the Fetal Growth Patterns of Singletons, Twins, and Triplets in the United States?'' Clinical Obstetrics and Gynecology 41, no. 1 (1998):115-125.

Bérard, J., P. Dufour, D. Vinatier, D. Subtil, S. Vanderstichele, J. C. Monnier, and F. Puech. ''Fetal Macrosomia: Risk Factors and Outcome.'' European Journal of Obstetrics and Gynecology and Reproductive Biology 77, no. 1 (1998):51-59.

Berkowitz, G. S., and Emile Papiernik. ''Epidemiology of Preterm Birth.'' Epidemiologic Review 15 (1993):414-444.

Dunham, Ethel, and Paul McAlenney. "A Study of 244 Prematurely Born Infants.'' Journal of Pediatrics 9 (1936):717-727.

Gregory, Kimberly, Olivia Henry, Emily Ramicone, Linda Chan, and Lawrence Platt. ''Maternal and Infant Complications in High and Normal Weight Infants by Method of Delivery.'' Obstetrics and Gynecology 92 (1998):507-513.

Guyer, Bernard, Marian MacDorman, Joyce Martin, Kimberely Peters, and Donna Strobino. "Annual Summary of Vital Statistics, 1997.'' Pediatrics 102 (1998):1333-1349.

Hack, Maureen, Nancy Klein, and H. Gerry Taylor. ''Long-Term Developmental Outcomes of Low Birth Weight Infants.'' Future of Children 5, no. 1 (1995):176-196.

Hughes, Dana, and Lisa Simpson. ''The Role of Social Change in Preventing Low Birth Weight.'' Future of Children 5, no. 1 (1995):87-103.

Institute of Medicine, Committee to Study the Prevention of Low Birth Weight. Preventing Low Birth Weight. Washington, DC: National Academy Press, 1985.

Kolderup, Lindsey, Russell Laros, and Thomas Musci. ''Incidence of Persistent Birth Injury in Macrosomic Infants: Association with Mode of Delivery.'' American Journal of Obstetrics and Gynecology 177, no. 1 (1997):37-41.

Kramer, Michael. "Determinants of Low Birth Weight: Methodological Assessment and Meta-analysis.'' Bulletin of the World Health Organization 65 (1987):663-737.

Kramer, Michael, Louise Séguin, John Lydon, and Lise Goulet. ''Socio-Economic Disparities in Pregnancy Outcome: Why Do the Poor Fare So Poorly?'' Paediatric and Perinatal Epidemiology 14 (2000):194-210.

Paneth, Nigel. ''The Problem of Low Birth Weight.'' Future of Children 5, no. 1 (1995):19-34.

Sacks, David, and Wansu Chen. ''Estimating Fetal Weight in the Management of Macrosomia.'' Obstetrical and Gynecological Survey 55 (2000):229-239.

Shiono, Patricia, Virginia Rauh, Mikyung Park, Sally Lederman, and Deborah Zuskar. ''Ethnic Differences in Birthweight: The Role of Lifestyle and Other Factors.'' American Journal of Public Health 87 (1997):787-793.

Thomson, A. M., and Soloman Leonard Barron, eds. ''Perinatal Mortality.'' Obstetrical Epidemiology. London: Academic Press, 1983.

Tompkins, Mark, Greg Alexander, Kirby Jackson, Carlton Hornung, and Joan Altekruse. ''The Risk of Low Birth Weight: Alternative Models of Neonatal Mortality.'' American Journal of Epidemiology 122 (1985):1067-1079.

World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Sixth Revision, Adopted 1948. Geneva: World Health Organization, 1948.

Martha Slay Greg R. Alexander Mary Ann Pass

Pregnancy And Childbirth

Pregnancy And Childbirth

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