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Complications
By Mayo Clinic staffFetal macrosomia poses health risks for you and your baby — both during pregnancy and after childbirth.
Maternal risks
Possible maternal complications of fetal macrosomia might include:
- Labor problems. Fetal macrosomia can cause a baby to become wedged in the birth canal, sustain birth injuries, or require the use of forceps or a vacuum device during delivery (operative vaginal delivery). Sometimes a C-section is needed.
- Genital tract lacerations. During childbirth, fetal macrosomia can cause a baby to injure the birth canal — such as by tearing vaginal tissues and the muscles between the vagina and the anus (perineal muscles).
- Bleeding after delivery. Fetal macrosomia increases the risk that your uterine muscles won't properly contract after you give birth (uterine atony). This can lead to potentially serious bleeding after delivery.
- Uterine rupture. If you've had a prior C-section or major uterine surgery, fetal macrosomia increases the risk of uterine rupture — a rare but serious complication in which the uterus tears open along the scar line from the C-section or other uterine surgery. An emergency C-section is needed to prevent life-threatening complications.
Newborn and childhood risks
Possible complications of fetal macrosomia for your baby might include:
- Higher than normal blood sugar level. A baby diagnosed with fetal macrosomia is more likely to be born with a blood sugar level that's higher than normal (impaired glucose tolerance).
- Childhood obesity. Research suggests that the risk of childhood obesity increases as birth weight increases.
- Metabolic syndrome. Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist or abnormal cholesterol levels — that occur together, increasing the risk of heart disease, stroke and diabetes. If your baby is diagnosed with fetal macrosomia, he or she is at risk of developing metabolic syndrome during childhood.
Further research is needed to determine whether these effects might increase the risk of adult diabetes, obesity and heart disease.
References
- American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth Month to Month. 5th ed. Washington, D.C.: American College of Obstetricians and Gynecologists; 2010:241.
- Abramocwicz JS, et al. Fetal macrosomia. http://www.uptodate.com/index. Accessed March 13, 2012.
- Rodis JF. Timing and route of delivery in pregnancies at risk of shoulder dystocia. http://www.uptodate.com/index. Accessed March 13, 2012.
- Mandy GT. Large for gestational age newborn. http://www.uptodate.com/index. Accessed March 13, 2012.
- Cunningham FG, et al. Williams Obstetrics. 23rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aID=6036563. Accessed March 14, 2012.
- DeCherney AH, et al.. Current Diagnosis & Treatment Obstetrics & Gynecology. 10th ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aID=2384988. Accessed March 14, 2012.
- Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2008. http://www.danforthsobgyn.com. Accessed March 19, 2012.
- Chatfield J. ACOG issues guidelines on fetal macrosomia. American Family Physician. 2001;64:169.
- Rodis JF. Intrapartum management and outcome of shoulder dystocia. http://www.uptodate.com/index. Accessed March 20, 2012.
- Routine prenatal care. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/guidelines_and_more/gl_os_prot/womens_health/prenatal_care_4/prenatal_care__routine__3.html. Accessed March 20, 2012.
- Tse G, et al. Weight gain and loss in pregnancy. http://www.uptodate.com/index. Accessed March 20, 2012.
- Mulik, et al. The outcome of macrosomic fetuses in a low risk primigravid population. International Journal of Gynecology and Obstetrics. 2003;80:15.
- Hackmon R, et al. Combined analysis with amniotic fluid index and estimated fetal weight for prediction of severe macrosomia at birth. American Journal of Obstetrics and Gynecology. 2007;196:333.e1.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins - Obstetrics. ACOG Practice Bulletin No.60. Pregestational diabetes mellitus. Obstetrics & Gynecology. 2005;105:675.
- Raio L, et al. Perinatal outcome of fetuses with a birth weight greater than 4500 g: An analysis of 3356 cases. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2003;109:160.
- Special tests for monitoring fetal health. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp098.cfm. Accessed March 20, 2012.
- Gillen-Goldstein J, et al. Assessment of fetal lung maturity. http://www.uptodate.com/index. Accessed March 20, 2012.
- Wegner EK, et al. Operative vaginal delivery. http://www.uptodate.com/index. Accessed March 21, 2012.
- McCulloch DK, et al. Prediction and prevention of type 2 diabetes. http://www.uptodate.com/index. Accessed March 21, 2012.
- What is metabolic syndrome? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/ms/. Accessed March 21, 2012.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2012.
- Cleary-Goldman J, et al. Impact of maternal age on obstetric outcome. Obstetrics & Gynecology. 2005;105:983.
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