Fetale Macrosomie

Fetal macrosomia – what does it mean?

Macrosomia, often used synonymously with fetal hypertrophy, refers to a baby that is too large in relation to gestational age. Macrosomia should be used for newborns, hypertrophy for babies before birth. Nevertheless, the two terms are interchangeable in everyday life.

A baby that is too big for its gestational age is said to be born when its estimated weight at a particular week of pregnancy exceeds the 90th percentile. Macrosomia, on the other hand, is when the birth weight is more than 4 kilograms.

Causes of fetal macrosomia

One of the most common causes of fetal macrosomia is diabetes in the mother. This results in an excessive increase in the baby’s body fat and thus an excessively high body weight. There is also an increased risk of macrosomia if the woman has already given birth to children with a high birth weight and if she herself struggles with obesity. The risk also increases after the age of 35.

Fetal macrosomia – complications

Excessive weight in relation to gestational age can be associated with serious complications for both the child and the mother. With macrosomia, there is a significantly increased risk of shoulder dystocia during natural birth, i.e. entrapment of the shoulders in the birth canal. This in turn can lead to injuries such as brachial plexus paralysis or clavicle fracture. Babies whose mothers had poorly controlled diabetes are more likely to have hypoglycaemia after birth, in addition to being overweight. Children born to mothers with diabetes are more likely to develop problems with obesity and metabolic syndrome later on.

For the pregnant woman, fetal macrosomia can also bring complications. The most common include: perinatal trauma to the birth canal, uterine rupture in the caesarean scar or poorer uterine contraction after birth and associated postpartum haemorrhage.

Fetal macrosomia – how can it be prevented?

To avoid weighing too much in relation to the baby’s gestational age, you should pay particular attention to your weight during pregnancy. The more a woman weighs before pregnancy, the less weight she should gain during pregnancy. Sufficient physical activity is also important, provided there are no medical contraindications. Regular walking and exercise can reduce the weight gain of the expectant mother and thus the risk of macrosomia in the foetus. In diabetes, it is important to maintain normal blood glucose levels to avoid abnormal diabetes control and the development of macrosomia.