Big Pregnant Birth
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Big Pregnant Birth
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Fetal macrosomia is when a baby growing larger than expected in utero. Find out more about macrosomia and what to do about it.
What to Expect When You're Expecting , 5th edition, Heidi Murkoff. WhatToExpect.com , Your Newborn’s Weight: Normal Gains and Losses and What the Average Baby Weighs , August 2020. WhatToExpect.com , Type 2 Diabetes During Pregnancy , February 2021. WhatToExpect.com , How Does Gestational Diabetes (GD) Affect Your Pregnancy and Baby? , December 2020. WhatToExpect.com , Uterine Rupture During Pregnancy , December 2020. American College of Obstetricians and Gynecologists, Obstetrics & Gynecology , Macrosomia , January 2020. American College of Obstetricians and Gynecologists, When Pregnancy Goes Past Your Due Date , 2017. American College of Obstetricians and Gynecologists, Gestational Diabetes Mellitus , February 2018. American College of Obstetricians and Gynecologists, Obesity and Pregnancy , May 2021. American College of Obstetrics and Gynecology, Exercise During Pregnancy , 2020. American College of Obstetrics and Gynecology, Assisted Vaginal Delivery , 2021. Centers for Disease Control and Prevention, Type 1 or Type 2 Diabetes During Pregnancy , July 2020. Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics Reports, Births: Final Data for 2017 , November 2018. Cleveland Clinic, Fetal Macrosomia , July 2018. Mayo Clinic, Fetal Macrosomia , May 2018. National Institutes of Health, National Library of Medicine, High Pregnancy Weight Gain and Risk of Excessive Fetal Growth , July 2009. National Institutes of Health, National Library of Medicine, Risk Factors for Recurrent Macrosomia and Child Outcomes , June 2019. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes Diet, Eating, & Physical Activity , December 2016. Stanford Children’s Health, Large for Gestational Age , 2022.
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The average newborn baby weighs 7½ pounds at birth. But some grow much larger. In fact, there's a technical term for babies weighing more than 8 pounds 13 ounces when they're born.
Called macrosomia, it affects around 8 percent of infants. Most macrosomic babies are born perfectly healthy without complications. But babies born on the bigger side can face some risks.
Here’s a look at how macrosomia happens, how it might affect you and your baby, and what you can do to reduce your risk or manage the condition if you have it.
When an infant weighs more than 8 pounds 13 ounces at birth, she’s considered a "big baby" — or one with macrosomia.
Macrosomia can occur when a baby gets more nutrients in utero than she needs, causing her to grow faster and larger than usual. However, some babies are just genetically programmed to be taller or bigger than others.
Doctors aren’t always sure why some newborns end up bigger than others, since some women with no discernible risks give birth to babies with macrosomia. But there are some factors that can increase the chance of having a big baby. These include:
Having gestational, type 1 or type 2 diabetes. That’s especially true if your diabetes isn’t well-managed.
Being obese or gaining too much weight during pregnancy. Macrosomia is more likely when women who were at a healthy weight before becoming pregnant gain more than 35 pounds, or those who were obese gain more than 20.
Having a macrosomic baby before. The risk of macrosomia increases with each pregnancy.
Being pregnant past 40 weeks. The longer your baby is in utero, the more time she has to grow.
Being born with macrosomia yourself. If you were a big baby, your newborn is more likely to be big too.
It can be tough to get a sense of your baby’s exact weight while she’s still in utero. For that reason, macrosomia isn’t officially diagnosed until after you’ve given birth.
But before then, your practitioner can get a sense of whether your baby might be big by looking at your medical history along with:
Measuring your fundal height . This is the distance between the top of your growing uterus and your pubic bone. Having a higher-than-expected height could mean a larger baby.
Manually feeling your abdomen. Touching your belly can also give a sense of your baby’s overall size. This can be a little uncomfortable for you, but rest assured — it doesn’t hurt the baby.
Conducting regular ultrasounds. Ultrasounds can offer a rough idea of your baby’s weight as well as the level of amniotic fluid. Excessive amniotic fluid — a condition known as polyhydramnios — is often associated with macrosomia. Larger babies pee out larger quantities of urine, and more urine means more amniotic fluid.
Macrosomia can be unpredictable, and there’s no guaranteed way to prevent it. The good news is that there are steps you can take to reduce your baby’s risk.
First up? Do what you can to keep your blood sugar in check if you have type 1, type 2 or gestational diabetes . Too-high glucose levels can cause your baby to get more nutrients than she needs, raising the risk for macrosomia.
Talk to your practitioner about the best ways to control your diabetes while pregnant, like eating a diet that’s high in complex carbohydrates and dietary fiber and low in cholesterol, saturated fat and refined sugars.
Take steps to maintain a healthy weight, too, whether you have diabetes or not. If you gained too much during a prior pregnancy or are worried about gaining an excessive amount during this pregnancy , talk to your doctor about safe ways to keep your weight gain steady .
Most pregnant women are advised to fit in at least 30 minutes of low-intensity exercise (like walking, yoga or swimming) five days a week and to follow a healthy diet featuring plenty of whole grains, vegetables, fruits and lean protein.
Simply put, bigger babies can sometimes be harder to push out. Many moms whose babies have macrosomia are still able to deliver vaginally.
If your baby is growing big, your practitioner will want you to give birth in the hospital in case a forceps delivery , a vacuum-assisted delivery or a C-section become necessary.
There are some cases where your doctor might recommend a C-section in advance though, including:
If your doctor suspects your baby is larger than 9 pounds 15 ounces and you have diabetes.
If your doctor suspects your baby is larger than 11 pounds and you don’t have diabetes.
If you previously delivered a baby with shoulder dystocia — where a baby’s shoulder gets stuck behind the mother’s pelvic bone.
No matter how your baby arrives, she’ll be examined for blood sugar problems or any potential birth injuries. You’ll need to be tested for diabetes, too, if you weren’t diagnosed during pregnancy.
Macrosomia is manageable, but it can pose some potential risks for both moms and babies — particularly when a baby is born weighing more than 9 pounds 15 ounces.
Babies born vaginally could be more likely to experience an injury like shoulder dystocia , where the baby’s shoulder gets stuck behind the mother’s pelvic bone.
If your practitioner suspects shoulder dystocia, he or she might try to manipulate your baby to encourage her to change positions or have you change positions. If that doesn’t work, your doctor may use a vacuum device or forceps or recommend an emergency C-section.
The more challenging labor could create some added risks for moms as well.
Bigger babies can sometimes cause vaginal tearing or increased bleeding after delivery. Moms who have previously undergone a C-section also have a higher chance for uterine rupture — a rare but serious complication where the uterus tears open along your scar line.
After a macrosomic baby is born, she's more likely to require a short stay in the NICU for low blood sugar, jaundice or trouble breathing. But keep in mind: Most little ones born with macrosomia have no complications at all and should be able to go home with you as soon as you’re ready.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting . What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy .
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The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. This educational content is not medical or diagnostic advice. Use of this site is subject to our terms of use and privacy policy . © 2022 Everyday Health, Inc
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According to statistics, 10% of babies experience macrosomia. This medical condition may involve risks at birth. The bigger is the baby, the bigger are the risks involving the birth.
The normal weight of a newborn is of up to 4 kg. Anything over this limit involves a macrosomic baby, which means a fetus with a weight over the normal limit.
As most statistics show, 10% of babies are macrosomic. Although they have a weight higher than the normal limit, this doesn`t mean their life is influenced in a negative way.
The first clue is represented by the mother`s tummy. If this is too large in relation with the gestational age of pregnancy, then the doctor might assume that the fetus is macrosomic . However, before pregnancy is very hard to if and how big will the baby be, even by ultrasound. After birth and when the baby is weighed, the doctor can pronounce himself.
The determinant causes for this medical condition split in primary and secondary. Among the primary causes are large vessels, Wiedemann-Beckwith syndrome, Sotos syndrome. All these pathologies present as common symptoms the excessive intrauterine growth associated with different abnormalities.
Among the secondary causes with an essential role is played by glucose metabolism abnormalities, mainly gestational diabetes or maternal insulin-dependent diabetes. Women with diabetes present during the last trimester of pregnancy hyperglycemia. A percentage of 75% from the concentration of mother`s glucose will pass to the fetus, crossing the placenta through a process known as facilitated diffusion process. Therefore, the baby becomes hyperinsulinemic, because of the increased insulin secretion and excessively anabolic. Glycogen surplus accumulates in the liver, and triglycerides will deposit in the adipose cells, therefore leading to the increase of the subcutaneous fat. – More info !
Another factor for macrosomia is determined by the difficulties of homeostatsis difficulties.
The rhythm of baby growth doesn`t determine a simultaneous acceleration of his maturation. Although they seem gigantic at first sight, they are less mature than you would expect.
The poor metabolic state will prevent them to adapt to the extrauterine life as other babies born at term. Macrosomic children will encounter difficulties regarding their resistance to the transient hypocaloric regimen that follows the umbilical cord`s clamping, because hyperinsulinism decreases glycemia.
The children of diabetic mothers present an increased risk of polycysticemia, idiopathic respiratory distress, hypocalcaemia, renal vein thrombosis.
Macrosomia can also be caused by the increased extracellular volume, secondary to placental growth in case of placental corioanginoma or fetoplacentar anemia.
The excess weight of the mothers is another important factor of this medical condition. Mothers with extra weight give birth to children with a greater weight than 4.000 g.
Most of the times, the only cause for macrosomia is the genetic factor.
If we are talking about the factors which can be controlled, the most important of these is the future mother`s increased levels of blood sugar. The high blood sugar may caused by gestational diabetes.
However, macrosomic children can have obese mothers as well, especially if they gain weight during pregnancy. – Read this !
An important aspect is also the baby`s gender, as boys have a larger weight than girls.
Mothers who already gave birth to a macrosomic child have higher chances to repeat to have another macrosomic child in a future pregnancy.
Still, mothers who show these risk factors don`t need to concern themselves. It`s possible for the newborn to have a normal weight, just as a mother who doesn`t show any risk factors can have a macrosomic child.
The high variations of weight at birth couldn`t be explained by experts yet.
As already mentioned, macrosomia can lead to a lot of birth issues. The bigger is the fetus, the higher are the risks for the birth to be more difficult.
The mother may experience coccyx wounds, perineal injuries or haemorrhage. Also, there`s also the risk of shoulder distress, which means that the fetus may remain with his shoulder stuck behind the mother`s pubic bone and unable to move forward. This is a very serious and rare birth complication which requires immediate resolution, so the baby won`t be affected severely.
Macrosomia also means more chances for Caesarean birth. Although is hard to establish the fetus`s weight before birth, the doctor may decide if he performs C-section to a mother with a large belly only to avoid complication.
If the birth is complicated, the newborn`s problems will be related to those respective complications. Shoulder distress may lead to a clavicle fracture, which eventually may heal with any issues. Otherwise, macrosomia isn`t associated with severe health issues. – Click here !
Bigger problems may have the mother if she gives birth naturally. Depending on the wounds he experienced in her perineum, restoration might take more or less time. However, the mothers who follow the advice of a specialist doctor shouldn`t find any long-term issues.
The diagnosis is placed based on the paraclinic investigations (pelvic ultrasound) and history.
The treatment for this medical condition doesn`t present any symptoms. Depending on each personal case, surgery for treating various fractures, or oxygen therapy for perinatal asphyxia.
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All What to Expect content that addresses health or safety is medically reviewed by a team of vetted health professionals. Our Medical Review Board includes OB/GYNs, pediatricians, infectious disease specialists, doulas, lactation counselors, endocrinologists, fertility specialists and more.
Here's what to know if your practitioner tells you that you're "measuring big."
What to Expect When You're Expecting , 5th edition, Heidi Murkoff. WhatToExpect.com , Macrosomia , April 2020. WhatToExpect.com , Gestational Diabetes During Pregnancy , December 2020. WhatToExpect.com , Fundal Height , May 2020. Mayo Clinic, What's the Significance of a Fundal Height Measurement? March 2020.
Top 1,000 Baby Girl Names in the U.S.
Top 1,000 Baby Boy Names in the U.S.
Braxton Hicks Contractions and False Labor
Find advice, support and good company (and some stuff just for fun).
We believe you should always know the source of the information you're reading. Learn more about our editorial and medical review policies .
"I just came from my 32-week appointment, and my doctor says I measured 35 weeks. I'm afraid my baby will be too big to deliver vaginally."
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