Macrosomic newborns of non-diabetic mothers: anthropometric measurements and neonatal complications

Abstract

Objective To assess the association of anthropometric measurements with neonatal complications in macrosomic newborns of non-diabetic mothers.

Incidence and Risk Factors of Hypoglycaemia in Large-For-Gestational Age Newborns of Non-Diabetic Mothers in a Tertiary Care Hospital

“…The incidence of hypoglycaemia significantly increased from 8% of the neonates in the group <4500 grams to 31% in the group 4500-5000 grams which further rose to 50% in neonates >5000 grams and above (p=.005). Schaefer-Graf et al 18 too, reported that out of the total hypoglycaemic LGA babies, 55.9% of them had an increase in incidence of hypoglycemia with increase in birth weight. Hypoglycaemia was also positively associated with birth weight, ranging from 0.8% in infants with a birth weight of 4000-4499 gm to 25% in infants with a birth weight of ≥5000 gm when compared to appropriate for gestational age (AGA) babies (p=0.008).…”

“…Hypoglycaemia was also positively associated with birth weight, ranging from 0.8% in infants with a birth weight of 4000-4499 gm to 25% in infants with a birth weight of ≥5000 gm when compared to appropriate for gestational age (AGA) babies (p=0.008). 18 The increase in incidence of hypoglycemia with increase in weight is due to the fact that the larger the baby, more will be his metabolic and caloric requirement. Therefore, these babies should be immediately fed by direct breast feeding or formula feed if mother is unable to initiate breast feeding for any reason.…”

Gestational diabetes and the neonate: challenges and solutions

“…36 Potential birth injuries include brachial plexus injuries (including Erb's palsy) and fractures of the clavicle and humerus. In a large cohort study in the United States, Zhang et al 37 confirmed that the risk of birth injury increases with birth weight: odds ratio (OR) =2.4 (95% confidence interval [CI] =2.2-2.5) with a birth weight between 4,500 and 4,999 g, and OR =3.5 (95% CI =3.0-4.2) with a birth weight .5,000 g. In a study of perinatal outcomes in women with and without GDM, Esakoff et al 38 found that GDM increases the odds of shoulder dystocia (adjusted odds ratios …”

Hyperinsulinism in neonates of diabetic mothers: guardian of the brain?

“…Macrosomic newborns are predisposed to selected adverse perinatal outcomes such as birth asphyxia brain damage [6]. However, there is no evidence for greater incidence of brain damage from perinatal asphyxia in infants of diabetic mothers compared with nondiabetic population [4,7]. Moreover, it has been shown that gestational diabetes neither increases the risk for such conditions when it is not treated [1].…”

“…Concordantly, it has been observed that perinatal nerve palsy is rare in the case of gestational diabetes [1]. Conversely, macrosomic infants of nondiabetic mothers have been demonstrated to be more susceptible to neonatal complications including cerebral palsy and neonatal encephalopathy [7]. Neonatal hypoxicischemic encephalopathy represents a serious cerebral event occurring around birth with high mortality and neurological morbidity linked to long-term invalidating sequelae [8].…”