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Slovenska pediatrija 2020; 27: 127-132

https://doi.org/10.38031/slovpediatr-2020-3-04

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Review article

LARGE-FOR-GESTATIONAL-AGE NEWBORNS: CAUSES AND CONSEQUENCES

Mojca Železnik
Klinični oddelek za neonatologijo, Univerzitetni klinični center Ljubljana Ljubljana, Slovenija

Aneta Soltirovska Šalamon
Klinični oddelek za neonatologijo Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Abstract

Large-for-gestational-age newborns are defined as having a birth weight and/or birth length above the 90th percentile for gestational age and sex. Through epigenetic mechanisms, the suboptimal intrauterine environment influences the phenotypic changes in the metabolic and endocrine pathways of the foetus. Excessive foetal growth leads to prenatal and postnatal complications, such as preterm birth, perinatal hypoxia, injuries, transient metabolic disorders, polycythaemia, and jaundice. In the long term, excessive foetal growth increases the risk of developing metabolic and cardiovascular diseases and disorders of the central nervous system. Aetiologically, the most important cause of macrosomia is gestational diabetes, which may remain unrecognised when it occurs after the 28th week of pregnancy since an active search for diabetes in pregnant women is performed before that time.

Key words: gestational diabetes, large-for-gestational-age, long-term health outcomes, macrosomia, newborn