Large for gestational age and fetal macrosomia · gemini-3.5-flash-lite · Nov 6, 8:34 AM ET
Macrosomia - Wiki.txt · Large for gestational age and fetal macrosomia
linguistic · employ a term for description
Infinitive. to use
Past. used
Past participle. used
Gerund. using
Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age.
Actors: term, infants
Done to: term
linguistic · characterize or represent
Infinitive. to describe
Past. described
Past participle. described
Gerund. describing
Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age.
Actors: term, infants
Done to: infants
Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age.
Actors: Macrosomia, birth weight
Done to: birth weight
biological · come into existence
Infinitive. to be born
Past. was born
Past participle. born
Gerund. being born
Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age.
Actors: infants
Done to: infants
Although larger babies are at higher risk for shoulder dystocia, most cases of shoulder dystocia happen in smaller babies because there are many more small and normal-size babies being born than large babies.
Actors: babies
Done to: babies
Studies have shown that higher levels of triglyceride and remnant cholesterol early in pregnancy are linked to faster fetal growth and a greater chance of the baby being born larger than average for its gestational age.
Actors: baby
Done to: baby
linguistic · allude or point to
Infinitive. to refer
Past. referred
Past participle. referred
Gerund. referring
Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age.
Actors: Macrosomia, measurement
Done to indirectly: measurement
medical · identify a medical condition
Infinitive. to diagnose
Past. diagnosed
Past participle. diagnosed
Gerund. diagnosing
Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams (8 lb 13 oz and 9 lb 15 oz), or more, measured at birth, but there are difficulties reaching a universal agreement of this definition.
Actors: threshold, macrosomia
Done to: macrosomia
While ultrasound has been the primary method for diagnosing LGA, this form of fetal weight assessment remains imprecise, as the fetus is a highly variable structure in regards to density and weight— no matter the gestational age.
Actors: ultrasound, LGA
Done to: LGA
clinical · ascertain size or weight
Infinitive. to measure
Past. measured
Past participle. measured
Gerund. measuring
Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams (8 lb 13 oz and 9 lb 15 oz), or more, measured at birth, but there are difficulties reaching a universal agreement of this definition.
Actors: body weight, birth
Done to: body weight
At time: at birth
Fundal height can be measured from the top of the uterus to the pubic bone and indicates that the newborn is likely large in volume.
Actors: Fundal height
Done to: Fundal height
Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.
Actors: Clinical methods, symphysis-fundal height
Done to: symphysis-fundal height
New methods are being studied for their accuracy in predicting fetal weight, such as measuring fetal soft tissue, but more research needs to be done to find a consistent, reliable method.
Actors: New methods, fetal soft tissue
Done to: fetal soft tissue
general · attain or achieve
Infinitive. to reach
Past. reached
Past participle. reached
Gerund. reaching
Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams (8 lb 13 oz and 9 lb 15 oz), or more, measured at birth, but there are difficulties reaching a universal agreement of this definition.
Actors: difficulties, agreement
Done to: agreement
clinical · assess or appraise
Infinitive. to evaluate
Past. evaluated
Past participle. evaluated
Gerund. evaluating
Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality.
Actors: infant, macrosomia, LGA
Done to: infant
Diagnosing fetal macrosomia cannot be performed until after birth, as evaluating a baby's weight in the womb may be inaccurate.
Actors: baby, weight
Done to: weight
general · assist or aid
Infinitive. to help
Past. helped
Past participle. helped
Gerund. helping
Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality.
Actors: infant, risks
Can cause: identify
Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.
Actors: Clinical methods, Leopold's maneuvers
Can cause: determining
clinical · recognize or establish
Infinitive. to identify
Past. identified
Past participle. identified
Gerund. identifying
Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality.
Actors: infant, risks
Done to: risks
Maternal gut microbiome: A correlation has been identified between the maternal gut microbiome and macrosomia in recent research.
Actors: Maternal gut microbiome, correlation
Done to: correlation
general · connect or link
Infinitive. to associate
Past. associated
Past participle. associated
Gerund. associating
Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality.
Actors: risks, birth
Done to: risks
It has also been shown that different patterns of excess fetal growth are seen in diabetic associated macrosomia compared to other predisposing factors, suggesting different underlying mechanisms.
Actors: macrosomia
Done to: macrosomia
Specifically, macrosomic infants associated with glucose abnormalities are seen to have increased body fat, larger shoulders, and abdominal circumference.
Actors: macrosomic infants, glucose abnormalities
Done to: macrosomic infants
general · comprise or contain
Infinitive. to include
Past. included
Past participle. included
Gerund. including
Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality.
Actors: risks, labor complications
Done to: labor complications
Important signs include large fundal height (uterus size) and excessive amniotic fluid (polyhydramnios).
Actors: signs, fundal height
Done to: fundal height, excessive amniotic fluid
Excessive amniotic fluid indicates that the fetus's urine output is larger than expected, indicating a larger baby than normal; some symptoms of excessive amniotic fluid include
Actors: amniotic fluid, symptoms
Done to: symptoms
Common risks in LGA babies include shoulder dystocia, low levels of blood sugar, brachial plexus injuries, metatarsus adductus, hip subluxation and talipes calcaneovalgus, due to intrauterine deformation.
Actors: risks, shoulder dystocia
Done to: shoulder dystocia
Complications of the pregnant mother include: emergency cesarean section, postpartum hemorrhage, and obstetric anal sphincter injury.
Actors: Complications, emergency cesarean section
Done to: emergency cesarean section
Multiple factors have been shown to increase the likelihood of infant macrosomia, including preexisting obesity, diabetes, or dyslipidemia of the mother, gestational diabetes, post-term pregnancy, prior history of a macrosomic birth, genetics, and other factors.
Actors: factors, obesity
Done to: obesity
The occurrence of macrosomia may be influenced by specific gut microbiota, including Bacteroides salyersiae, Bacteroides plebeius, Ruminococcus lactaris, and Bacteroides ovatus.
Actors: gut microbiota, Bacteroides salyersiae
Done to: Bacteroides salyersiae
clinical · display or exhibit symptoms
Infinitive. to present
Past. presented
Past participle. presented
Gerund. presenting
Fetal macrosomia and LGA often do not present with noticeable patient symptoms.
Actors: Fetal macrosomia, patient symptoms
Done to indirectly: patient symptoms
clinical · point out or signify
Infinitive. to indicate
Past. indicated
Past participle. indicated
Gerund. indicating
Fundal height can be measured from the top of the uterus to the pubic bone and indicates that the newborn is likely large in volume.
Actors: Fundal height, newborn
Done to: newborn
Excessive amniotic fluid indicates that the fetus's urine output is larger than expected, indicating a larger baby than normal; some symptoms of excessive amniotic fluid include
Actors: amniotic fluid, urine output
Done to: urine output
general · anticipate
Infinitive. to expect
Past. expected
Past participle. expected
Gerund. expecting
Excessive amniotic fluid indicates that the fetus's urine output is larger than expected, indicating a larger baby than normal; some symptoms of excessive amniotic fluid include
Actors: urine output
Done to: urine output
causative · result in or cause
Infinitive. to lead
Past. led
Past participle. led
Gerund. leading
LGA or macrosomic births can lead to complications for both the mother and the infant.
Actors: LGA, births, complications
Can result in: complications
Traditionally, the Pedersen hypothesis has been used to explain the mechanism by which uncontrolled gestational diabetes can lead to macrosomia, and many aspects of it have been confirmed with further studies.
Actors: gestational diabetes, macrosomia
Can result in: macrosomia
This explanation proposes that impaired glucose control in the mother leads to a hyperglycemic state for the fetus, which leads to a hyperinsulinemia response, in turn causing increased glucose metabolism, fat deposition, and excess growth.
Actors: glucose control, hyperglycemic state
Can result in: hyperglycemic state
general · happen or take place
Infinitive. to occur
Past. occurred
Past participle. occurred
Gerund. occurring
Shoulder dystocia occurs when the infant's shoulder becomes impacted on the mother's pubic symphysis during birth.
Actors: Shoulder dystocia
During: birth
In non-diabetic women, shoulder dystocia happens 0.65% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 6.7% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 14.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).
Actors: shoulder dystocia
Condition: in non-diabetic women
In diabetic women, shoulder dystocia happens 2.2% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 13.9% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 52.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).
Actors: diabetic women, shoulder dystocia
Condition: in diabetic women
Although larger babies are at higher risk for shoulder dystocia, most cases of shoulder dystocia happen in smaller babies because there are many more small and normal-size babies being born than large babies.
Actors: shoulder dystocia, babies
Hypoglycemia, as well as hyperbilirubinemia and polycythemia, occurs as a result of hyperinsulinemia in the fetus.
Actors: Hypoglycemia, hyperinsulinemia
Because of: hyperinsulinemia
clinical · have an effect upon
Infinitive. to impact
Past. impacted
Past participle. impacted
Gerund. impacting
Shoulder dystocia occurs when the infant's shoulder becomes impacted on the mother's pubic symphysis during birth.
Actors: shoulder, mother
Done to: shoulder
High birth weight may also impact the baby in the long term, as studies have shown associations with increased risk of overweight, obesity, and type 2 diabetes mellitus.
Actors: birth weight, baby
Done to: baby
At time: in the long term
general · make or become greater
Infinitive. to increase
Past. increased
Past participle. increased
Gerund. increasing
Both increased birth weight and diabetes in the gestational parent are independent risk factors seen to increase risk of shoulder dystocia.
Actors: birth weight, risk
Done to: risk
High birth weight may also impact the baby in the long term, as studies have shown associations with increased risk of overweight, obesity, and type 2 diabetes mellitus.
Actors: risk
Done to: risk
Multiple factors have been shown to increase the likelihood of infant macrosomia, including preexisting obesity, diabetes, or dyslipidemia of the mother, gestational diabetes, post-term pregnancy, prior history of a macrosomic birth, genetics, and other factors.
Actors: factors, likelihood
Done to: likelihood
Gestational age: pregnancies that go beyond 40 weeks increase the incidence of an LGA infant
Actors: pregnancies, incidence
Done to: incidence
This explanation proposes that impaired glucose control in the mother leads to a hyperglycemic state for the fetus, which leads to a hyperinsulinemia response, in turn causing increased glucose metabolism, fat deposition, and excess growth.
Actors: glucose metabolism
Done to: glucose metabolism
general · observe or note
Infinitive. to see
Past. saw
Past participle. seen
Gerund. seeing
Both increased birth weight and diabetes in the gestational parent are independent risk factors seen to increase risk of shoulder dystocia.
Actors: risk factors
Done to: risk factors
Genetics can also play a role in having an LGA baby, and it is seen that taller, heavier parents tend to have larger babies.
Actors: parents
It has also been shown that different patterns of excess fetal growth are seen in diabetic associated macrosomia compared to other predisposing factors, suggesting different underlying mechanisms.
Actors: patterns
Done to: patterns
Specifically, macrosomic infants associated with glucose abnormalities are seen to have increased body fat, larger shoulders, and abdominal circumference.
Actors: macrosomic infants
Done to: macrosomic infants
clinical · have a specified weight
Infinitive. to weigh
Past. weighed
Past participle. weighed
Gerund. weighing
In non-diabetic women, shoulder dystocia happens 0.65% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 6.7% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 14.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).
Actors: babies
Done to: babies
In diabetic women, shoulder dystocia happens 2.2% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 13.9% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 52.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).
Actors: babies
Done to: babies
The risk of type 2 diabetes mellitus as an adult is 19% higher in babies weighing more than 4,500 g at birth compared to those with birth weights between 4,000 g and 4,500 g.
Actors: babies
Done to: babies
Compared to pregnancies without macrosomia, pregnant women giving birth to newborns weighing between 4,000 grams and 4,500 grams are at twice the risk of complications, and those giving birth to infants over 4,500 grams are at three times greater risk.
Actors: newborns
Done to: newborns
Fetal sex: male infants tend to weigh more than female infants
Actors: male infants
Done to: male infants
general · demonstrate or exhibit
Infinitive. to show
Past. showed
Past participle. shown
Gerund. showing
High birth weight may also impact the baby in the long term, as studies have shown associations with increased risk of overweight, obesity, and type 2 diabetes mellitus.
Actors: studies, associations
Done to: associations
Studies have shown that the long-term overweight risk is doubled when the birth weight is greater than 4,000 g.
Actors: Studies, overweight risk
Done to: overweight risk
Multiple factors have been shown to increase the likelihood of infant macrosomia, including preexisting obesity, diabetes, or dyslipidemia of the mother, gestational diabetes, post-term pregnancy, prior history of a macrosomic birth, genetics, and other factors.
Actors: factors
Done to: factors
Studies have shown that higher levels of triglyceride and remnant cholesterol early in pregnancy are linked to faster fetal growth and a greater chance of the baby being born larger than average for its gestational age.
Actors: Studies, levels
Done to: levels
general · possess or experience
Infinitive. to have
Past. had
Past participle. had
Gerund. having
LGA babies are at higher risk of low blood sugar (hypoglycemia) in the neonatal period, independent of whether the mother has diabetes.
Actors: mother, diabetes
Done to: diabetes
The risk of having a macrosomic fetus is three times greater in mothers with diabetes than those without diabetes.
Actors: macrosomic fetus
Done to: macrosomic fetus
Genetics can also play a role in having an LGA baby, and it is seen that taller, heavier parents tend to have larger babies.
Actors: LGA baby, parents
Done to: LGA baby
Specifically, macrosomic infants associated with glucose abnormalities are seen to have increased body fat, larger shoulders, and abdominal circumference.
Actors: macrosomic infants, body fat
Done to: body fat
general · multiply by two
Infinitive. to double
Past. doubled
Past participle. doubled
Gerund. doubling
Studies have shown that the long-term overweight risk is doubled when the birth weight is greater than 4,000 g.
Actors: overweight risk, birth weight
Done to: overweight risk
Condition: birth weight is greater than 4,000 g
biological · give birth to
Infinitive. to give
Past. gave
Past participle. given
Gerund. giving
Compared to pregnancies without macrosomia, pregnant women giving birth to newborns weighing between 4,000 grams and 4,500 grams are at twice the risk of complications, and those giving birth to infants over 4,500 grams are at three times greater risk.
Actors: pregnant women, newborns
Done to: newborns
Multiparity: giving birth to previous LGA infants vs. non-LGA infants
Actors: Multiparity, birth
Done to: birth
general · advise or suggest
Infinitive. to recommend
Past. recommended
Past participle. recommended
Gerund. recommending
Obesity before pregnancy and maternal weight gain above recommended guidelines during pregnancy are other key risk factors for macrosomia or LGA infants.
Actors: recommended guidelines
Done to: guidelines
general · prove or show clearly
Infinitive. to demonstrate
Past. demonstrated
Past participle. demonstrated
Gerund. demonstrating
It has been demonstrated that while maternal obesity and gestational diabetes are independent risk factors for LGA and macrosomia, they can act synergistically, with even higher risk of macrosomia when both are present.
Actors: maternal obesity, gestational diabetes
Done to: risk factors
general · behave or function
Infinitive. to act
Past. acted
Past participle. acted
Gerund. acting
It has been demonstrated that while maternal obesity and gestational diabetes are independent risk factors for LGA and macrosomia, they can act synergistically, with even higher risk of macrosomia when both are present.
Actors: maternal obesity and gestational diabetes
How: synergistically
general · perform a part
Infinitive. to play
Past. played
Past participle. played
Gerund. playing
Genetics can also play a role in having an LGA baby, and it is seen that taller, heavier parents tend to have larger babies.
Actors: Genetics, role
Done to: role
general · be inclined to
Infinitive. to tend
Past. tended
Past participle. tended
Gerund. tending
Genetics can also play a role in having an LGA baby, and it is seen that taller, heavier parents tend to have larger babies.
Actors: parents, babies
Can cause: have
Fetal sex: male infants tend to weigh more than female infants
Actors: male infants
Can cause: weigh
general · describe the character or distinctive features
Infinitive. to characterize
Past. characterized
Past participle. characterized
Gerund. characterizing
Genetic disorders of overgrowth (e.g. Beckwith–Wiedemann syndrome, Sotos syndrome, Perlman syndrome, Simpson-Golabi-Behmel syndrome) are often characterized by macrosomia.
Actors: Genetic disorders, macrosomia
Done to: Genetic disorders
Because of: macrosomia
general · proceed or extend
Infinitive. to go
Past. went
Past participle. gone
Gerund. going
Gestational age: pregnancies that go beyond 40 weeks increase the incidence of an LGA infant
Actors: pregnancies, weeks
Done to: weeks
medical · move from one place to another
Infinitive. to transfer
Past. transferred
Past participle. transferred
Gerund. transferring
Frozen embryo transfer as fertility treatment, as compared with fresh embryo transfer or no artificial assistance
Actors: Frozen embryo transfer
Done to: embryo
general · have an effect on
Infinitive. to influence
Past. influenced
Past participle. influenced
Gerund. influencing
The occurrence of macrosomia may be influenced by specific gut microbiota, including Bacteroides salyersiae, Bacteroides plebeius, Ruminococcus lactaris, and Bacteroides ovatus.
Actors: occurrence, gut microbiota
Done to: occurrence
During pregnancy, the levels of fat (lipids) in a mother's blood can influence how the baby grows.
Actors: levels, baby
Done to: baby
cognitive · comprehend
Infinitive. to understand
Past. understood
Past participle. understood
Gerund. understanding
How each of these factors leads to excess fetal growth is complex and not completely understood.
Actors: factors
Done to: factors
cognitive · make clear or account for
Infinitive. to explain
Past. explained
Past participle. explained
Gerund. explaining
Traditionally, the Pedersen hypothesis has been used to explain the mechanism by which uncontrolled gestational diabetes can lead to macrosomia, and many aspects of it have been confirmed with further studies.
Actors: Pedersen hypothesis, mechanism
Done to: mechanism
general · establish the truth or validity of
Infinitive. to confirm
Past. confirmed
Past participle. confirmed
Gerund. confirming
Traditionally, the Pedersen hypothesis has been used to explain the mechanism by which uncontrolled gestational diabetes can lead to macrosomia, and many aspects of it have been confirmed with further studies.
Actors: aspects, studies
Done to: aspects
cognitive · put forward for consideration
Infinitive. to propose
Past. proposed
Past participle. proposed
Gerund. proposing
This explanation proposes that impaired glucose control in the mother leads to a hyperglycemic state for the fetus, which leads to a hyperinsulinemia response, in turn causing increased glucose metabolism, fat deposition, and excess growth.
Actors: explanation, glucose control
Done to: glucose control
medical · damage or weaken
Infinitive. to impair
Past. impaired
Past participle. impaired
Gerund. impairing
This explanation proposes that impaired glucose control in the mother leads to a hyperglycemic state for the fetus, which leads to a hyperinsulinemia response, in turn causing increased glucose metabolism, fat deposition, and excess growth.
Actors: glucose control
Done to: glucose control
causative · make happen
Infinitive. to cause
Past. caused
Past participle. caused
Gerund. causing
This explanation proposes that impaired glucose control in the mother leads to a hyperglycemic state for the fetus, which leads to a hyperinsulinemia response, in turn causing increased glucose metabolism, fat deposition, and excess growth.
Actors: hyperinsulinemia response, glucose metabolism
Can result in: glucose metabolism
cognitive · imply or indicate
Infinitive. to suggest
Past. suggested
Past participle. suggested
Gerund. suggesting
It has also been shown that different patterns of excess fetal growth are seen in diabetic associated macrosomia compared to other predisposing factors, suggesting different underlying mechanisms.
Actors: patterns, mechanisms
Done to: mechanisms
biological · develop or increase in size
Infinitive. to grow
Past. grew
Past participle. grown
Gerund. growing
During pregnancy, the levels of fat (lipids) in a mother's blood can influence how the baby grows.
Actors: baby
Done to: baby
general · connect or associate
Infinitive. to link
Past. linked
Past participle. linked
Gerund. linking
Studies have shown that higher levels of triglyceride and remnant cholesterol early in pregnancy are linked to faster fetal growth and a greater chance of the baby being born larger than average for its gestational age.
Actors: levels, fetal growth
Done to: fetal growth
Later in pregnancy, higher total cholesterol in the mother's blood has also been linked to higher birthweight, supporting the idea that maternal lipid levels can directly affect the baby's growth.
Actors: total cholesterol, birthweight
Done to: birthweight
Variability of fetal weight estimations has been linked to differences due to sensitivity and specificity of ultrasound algorithms as well as to the individual performing the ultrasound examination.
Actors: Variability, differences
Done to: Variability
general · provide evidence for
Infinitive. to support
Past. supported
Past participle. supported
Gerund. supporting
Later in pregnancy, higher total cholesterol in the mother's blood has also been linked to higher birthweight, supporting the idea that maternal lipid levels can directly affect the baby's growth.
Actors: birthweight, idea
Done to: idea
general · influence or produce a change in
Infinitive. to affect
Past. affected
Past participle. affected
Gerund. affecting
Later in pregnancy, higher total cholesterol in the mother's blood has also been linked to higher birthweight, supporting the idea that maternal lipid levels can directly affect the baby's growth.
Actors: maternal lipid levels, baby
Done to: baby
medical · carry out an action
Infinitive. to perform
Past. performed
Past participle. performed
Gerund. performing
Diagnosing fetal macrosomia cannot be performed until after birth, as evaluating a baby's weight in the womb may be inaccurate.
Actors: fetal macrosomia
Done to: fetal macrosomia
Variability of fetal weight estimations has been linked to differences due to sensitivity and specificity of ultrasound algorithms as well as to the individual performing the ultrasound examination.
Actors: individual, ultrasound examination
Done to: ultrasound examination
Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.
Actors: Clinical methods, Leopold's maneuvers
Done to: Leopold's maneuvers
general · include or absorb
Infinitive. to incorporate
Past. incorporated
Past participle. incorporated
Gerund. incorporating
Ultrasonography involves an algorithm that incorporates biometric measurements of the fetus, such as biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), to calculate the estimated fetal weight (EFW).
Actors: algorithm, biometric measurements
Done to: biometric measurements
clinical · determine mathematically
Infinitive. to calculate
Past. calculated
Past participle. calculated
Gerund. calculating
Ultrasonography involves an algorithm that incorporates biometric measurements of the fetus, such as biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), to calculate the estimated fetal weight (EFW).
Actors: algorithm, estimated fetal weight
Done to: estimated fetal weight
clinical · evaluate or estimate
Infinitive. to assess
Past. assessed
Past participle. assessed
Gerund. assessing
In addition to sonography, fetal weight can also be assessed using clinical and maternal methods.
Actors: fetal weight, clinical and maternal methods
Done to: fetal weight
clinical · roughly calculate
Infinitive. to estimate
Past. estimated
Past participle. estimated
Gerund. estimating
Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.
Actors: Clinical methods, fetal weight
Done to: fetal weight
Fetal weight can also be estimated through a mother's subjective assessment of the fetus's size, but this method is dependent on a mother's experience with past pregnancies and may not be clinically useful.
Actors: Fetal weight, mother
Done to: Fetal weight
general · include as a necessary part
Infinitive. to involve
Past. involved
Past participle. involved
Gerund. involving
Ultrasonography involves an algorithm that incorporates biometric measurements of the fetus, such as biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), to calculate the estimated fetal weight (EFW).
Actors: Ultrasonography, algorithm
Done to: algorithm
Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.
Actors: Clinical methods, symphysis-fundal height
Done to: symphysis-fundal height
clinical · ascertain or establish definitively
Infinitive. to determine
Past. determined
Past participle. determined
Gerund. determining
Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.
Actors: Leopold's maneuvers, position
Done to: position
general · depend on
Infinitive. to rely
Past. relied
Past participle. relied
Gerund. relying
However, as this method relies heavily on practitioner experience and technique, it does not provide an accurate and definite diagnosis of an LGA infant and would only serve as a potential indication of suspected macrosomia.
Actors: method, practitioner experience
Done to indirectly: practitioner experience
general · furnish or supply
Infinitive. to provide
Past. provided
Past participle. provided
Gerund. providing
However, as this method relies heavily on practitioner experience and technique, it does not provide an accurate and definite diagnosis of an LGA infant and would only serve as a potential indication of suspected macrosomia.
Actors: method, diagnosis
Done to: diagnosis
general · function as
Infinitive. to serve
Past. served
Past participle. served
Gerund. serving
However, as this method relies heavily on practitioner experience and technique, it does not provide an accurate and definite diagnosis of an LGA infant and would only serve as a potential indication of suspected macrosomia.
Actors: method, indication
Done to: indication
clinical · believe to be probable
Infinitive. to suspect
Past. suspected
Past participle. suspected
Gerund. suspecting
However, as this method relies heavily on practitioner experience and technique, it does not provide an accurate and definite diagnosis of an LGA infant and would only serve as a potential indication of suspected macrosomia.
Actors: indication, macrosomia
Done to: macrosomia
research · investigate or examine closely
Infinitive. to study
Past. studied
Past participle. studied
Gerund. studying
New methods are being studied for their accuracy in predicting fetal weight, such as measuring fetal soft tissue, but more research needs to be done to find a consistent, reliable method.
Actors: New methods
Done to: New methods
clinical · forecast or estimate
Infinitive. to predict
Past. predicted
Past participle. predicted
Gerund. predicting
New methods are being studied for their accuracy in predicting fetal weight, such as measuring fetal soft tissue, but more research needs to be done to find a consistent, reliable method.
Actors: New methods, fetal weight
Done to: fetal weight
general · require
Infinitive. to need
Past. needed
Past participle. needed
Gerund. needing
New methods are being studied for their accuracy in predicting fetal weight, such as measuring fetal soft tissue, but more research needs to be done to find a consistent, reliable method.
Actors: research
Done to: done
research · discover or locate
Infinitive. to find
Past. found
Past participle. found
Gerund. finding
New methods are being studied for their accuracy in predicting fetal weight, such as measuring fetal soft tissue, but more research needs to be done to find a consistent, reliable method.
Actors: research, method
Done to: method
other · medical condition
livingThing · newborn human
other · medical condition
other · measurement
individual · parent
other · anatomical measurement
naturalObject · fluid
livingThing · unborn human
other · medical complication
other · medical condition
other · medical condition
other · medical condition
other · biological factor
livingThing · bacteria
other · scientific hypothesis
manMadeObject · medical device
D6 - S1 · present · positive
Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age.
D6 - S2 · present · positive
Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age.
D6 - S3 · present · positive
Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams (8 lb 13 oz and 9 lb 15 oz), or more, measured at birth, but there are difficulties reaching a universal agreement of this definition.
D6 - S4 · present · positive
Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality.
D6 - S5 · present · negative · Signs and symptoms
Fetal macrosomia and LGA often do not present with noticeable patient symptoms.
D6 - S6 · present · positive · Signs and symptoms
Important signs include large fundal height (uterus size) and excessive amniotic fluid (polyhydramnios).
D6 - S7 · present · positive · Signs and symptoms
Fundal height can be measured from the top of the uterus to the pubic bone and indicates that the newborn is likely large in volume.
D6 - S8 · present · positive · Signs and symptoms
Excessive amniotic fluid indicates that the fetus's urine output is larger than expected, indicating a larger baby than normal; some symptoms of excessive amniotic fluid include
D6 - S9 · present · positive · Signs and symptoms
shortness of breath
D6 - S10 · present · positive · Signs and symptoms
swelling of lower extremities & abdominal wall
D6 - S11 · present · positive · Signs and symptoms
uterine discomfort or contractions
D6 - S12 · present · positive · Signs and symptoms
fetal malposition, such as breech presentation.
D6 - S13 · present · positive · Complications
LGA or macrosomic births can lead to complications for both the mother and the infant.
D6 - S14 · present · positive · Infant complications
Common risks in LGA babies include shoulder dystocia, low levels of blood sugar, brachial plexus injuries, metatarsus adductus, hip subluxation and talipes calcaneovalgus, due to intrauterine deformation.
D6 - S15 · present · positive · Infant complications
Shoulder dystocia occurs when the infant's shoulder becomes impacted on the mother's pubic symphysis during birth.
D6 - S16 · present · positive · Infant complications
Newborns with shoulder dystocia are at risk of temporary or permanent nerve damage to the baby's arm, or other injuries such as fracture.
D6 - S17 · present · positive · Infant complications
Both increased birth weight and diabetes in the gestational parent are independent risk factors seen to increase risk of shoulder dystocia.
D6 - S18 · present · positive · Infant complications
In non-diabetic women, shoulder dystocia happens 0.65% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 6.7% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 14.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).
D6 - S19 · present · positive · Infant complications
In diabetic women, shoulder dystocia happens 2.2% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 13.9% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 52.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).
D6 - S20 · present · positive · Infant complications
Although larger babies are at higher risk for shoulder dystocia, most cases of shoulder dystocia happen in smaller babies because there are many more small and normal-size babies being born than large babies.
D6 - S21 · present · positive · Infant complications
LGA babies are at higher risk of low blood sugar (hypoglycemia) in the neonatal period, independent of whether the mother has diabetes.
D6 - S22 · present · positive · Infant complications
Hypoglycemia, as well as hyperbilirubinemia and polycythemia, occurs as a result of hyperinsulinemia in the fetus.
D6 - S23 · present · positive · Infant complications
High birth weight may also impact the baby in the long term, as studies have shown associations with increased risk of overweight, obesity, and type 2 diabetes mellitus.
D6 - S24 · present · positive · Infant complications
Studies have shown that the long-term overweight risk is doubled when the birth weight is greater than 4,000 g.
D6 - S25 · present · positive · Infant complications
The risk of type 2 diabetes mellitus as an adult is 19% higher in babies weighing more than 4,500 g at birth compared to those with birth weights between 4,000 g and 4,500 g.
D6 - S26 · present · positive · Pregnant mother complications
Complications of the pregnant mother include: emergency cesarean section, postpartum hemorrhage, and obstetric anal sphincter injury.
D6 - S27 · present · positive · Pregnant mother complications
Compared to pregnancies without macrosomia, pregnant women giving birth to newborns weighing between 4,000 grams and 4,500 grams are at twice the risk of complications, and those giving birth to infants over 4,500 grams are at three times greater risk.
D6 - S28 · present · positive · Causes
Multiple factors have been shown to increase the likelihood of infant macrosomia, including preexisting obesity, diabetes, or dyslipidemia of the mother, gestational diabetes, post-term pregnancy, prior history of a macrosomic birth, genetics, and other factors.
D6 - S29 · present · positive · Risk factors
One of the primary risk factors of LGA births and macrosomia is poorly-controlled maternal diabetes, particularly gestational diabetes (GD), as well as preexisting type 2 diabetes mellitus (DM).
D6 - S30 · present · positive · Risk factors
The risk of having a macrosomic fetus is three times greater in mothers with diabetes than those without diabetes.
D6 - S31 · present · positive · Obesity in the mother
Obesity before pregnancy and maternal weight gain above recommended guidelines during pregnancy are other key risk factors for macrosomia or LGA infants.
D6 - S32 · present · positive · Obesity in the mother
It has been demonstrated that while maternal obesity and gestational diabetes are independent risk factors for LGA and macrosomia, they can act synergistically, with even higher risk of macrosomia when both are present.
D6 - S33 · present · positive · Genetics
Genetics can also play a role in having an LGA baby, and it is seen that taller, heavier parents tend to have larger babies.
D6 - S34 · present · positive · Genetics
Genetic disorders of overgrowth (e.g. Beckwith–Wiedemann syndrome, Sotos syndrome, Perlman syndrome, Simpson-Golabi-Behmel syndrome) are often characterized by macrosomia.
D6 - S35 · present · positive · Other risk factors
Gestational age: pregnancies that go beyond 40 weeks increase the incidence of an LGA infant
D6 - S36 · present · positive · Other risk factors
Fetal sex: male infants tend to weigh more than female infants
D6 - S37 · present · positive · Other risk factors
Multiparity: giving birth to previous LGA infants vs. non-LGA infants
D6 - S38 · present · positive · Other risk factors
Frozen embryo transfer as fertility treatment, as compared with fresh embryo transfer or no artificial assistance
D6 - S39 · present · positive · Other risk factors
Maternal gut microbiome: A correlation has been identified between the maternal gut microbiome and macrosomia in recent research.
D6 - S40 · present · positive · Other risk factors
The occurrence of macrosomia may be influenced by specific gut microbiota, including Bacteroides salyersiae, Bacteroides plebeius, Ruminococcus lactaris, and Bacteroides ovatus.
D6 - S41 · present · positive · Mechanism
How each of these factors leads to excess fetal growth is complex and not completely understood.
D6 - S42 · present · positive · Mechanism
Traditionally, the Pedersen hypothesis has been used to explain the mechanism by which uncontrolled gestational diabetes can lead to macrosomia, and many aspects of it have been confirmed with further studies.
D6 - S43 · present · positive · Mechanism
This explanation proposes that impaired glucose control in the mother leads to a hyperglycemic state for the fetus, which leads to a hyperinsulinemia response, in turn causing increased glucose metabolism, fat deposition, and excess growth.
D6 - S44 · present · positive · Mechanism
It has also been shown that different patterns of excess fetal growth are seen in diabetic associated macrosomia compared to other predisposing factors, suggesting different underlying mechanisms.
D6 - S45 · present · positive · Mechanism
Specifically, macrosomic infants associated with glucose abnormalities are seen to have increased body fat, larger shoulders, and abdominal circumference.
D6 - S46 · present · positive · Maternal Lipid metabolism
During pregnancy, the levels of fat (lipids) in a mother's blood can influence how the baby grows.
D6 - S47 · present · positive · Maternal Lipid metabolism
Studies have shown that higher levels of triglyceride and remnant cholesterol early in pregnancy are linked to faster fetal growth and a greater chance of the baby being born larger than average for its gestational age.
D6 - S48 · present · positive · Maternal Lipid metabolism
Later in pregnancy, higher total cholesterol in the mother's blood has also been linked to higher birthweight, supporting the idea that maternal lipid levels can directly affect the baby's growth.
D6 - S49 · present · negative · Diagnosis
Diagnosing fetal macrosomia cannot be performed until after birth, as evaluating a baby's weight in the womb may be inaccurate.
D6 - S50 · present · positive · Diagnosis
While ultrasound has been the primary method for diagnosing LGA, this form of fetal weight assessment remains imprecise, as the fetus is a highly variable structure in regards to density and weight— no matter the gestational age.
D6 - S51 · present · positive · Diagnosis
Ultrasonography involves an algorithm that incorporates biometric measurements of the fetus, such as biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), to calculate the estimated fetal weight (EFW).
D6 - S52 · present · positive · Diagnosis
Variability of fetal weight estimations has been linked to differences due to sensitivity and specificity of ultrasound algorithms as well as to the individual performing the ultrasound examination.
D6 - S53 · present · positive · Diagnosis
In addition to sonography, fetal weight can also be assessed using clinical and maternal methods.
D6 - S54 · present · positive · Diagnosis
Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.
D6 - S55 · present · negative · Diagnosis
However, as this method relies heavily on practitioner experience and technique, it does not provide an accurate and definite diagnosis of an LGA infant and would only serve as a potential indication of suspected macrosomia.
D6 - S56 · present · positive · Diagnosis
Fetal weight can also be estimated through a mother's subjective assessment of the fetus's size, but this method is dependent on a mother's experience with past pregnancies and may not be clinically useful.
D6 - S57 · present · positive · Diagnosis
New methods are being studied for their accuracy in predicting fetal weight, such as measuring fetal soft tissue, but more research needs to be done to find a consistent, reliable method.
Large for gestational age From Wikipedia, the free encyclopedia Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age.[1][2][3] Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age.[4] Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams (8 lb 13 oz and 9 lb 15 oz), or more, measured at birth, but there are difficulties reaching a universal agreement of this definition.[4] Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality.[5] Signs and symptoms Fetal macrosomia and LGA often do not present with noticeable patient symptoms. Important signs include large fundal height (uterus size) and excessive amniotic fluid (polyhydramnios).[6] Fundal height can be measured from the top of the uterus to the pubic bone and indicates that the newborn is likely large in volume. Excessive amniotic fluid indicates that the fetus's urine output is larger than expected, indicating a larger baby than normal; some symptoms of excessive amniotic fluid include • shortness of breath • swelling of lower extremities & abdominal wall • uterine discomfort or contractions • fetal malposition, such as breech presentation.[6] Complications LGA or macrosomic births can lead to complications for both the mother and the infant.[7] Infant complications Common risks in LGA babies include shoulder dystocia,[5] low levels of blood sugar,[5] brachial plexus injuries,[8] metatarsus adductus, hip subluxation[9] and talipes calcaneovalgus, due to intrauterine deformation.[9] Shoulder dystocia occurs when the infant's shoulder becomes impacted on the mother's pubic symphysis during birth.[10] Newborns with shoulder dystocia are at risk of temporary or permanent nerve damage to the baby's arm, or other injuries such as fracture.[11] Both increased birth weight and diabetes in the gestational parent are independent risk factors seen to increase risk of shoulder dystocia.[11] In non-diabetic women, shoulder dystocia happens 0.65% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 6.7% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 14.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).[12] In diabetic women, shoulder dystocia happens 2.2% of the time in babies that weigh less than 8 pounds 13 ounces (4,000 g), 13.9% of the time in babies that weigh 8 pounds (3,600 g) to 9 pounds 15 ounces (4,500 g), and 52.5% of the time in babies that weigh more than 9 pounds 15 ounces (4,500 g).[12] Although larger babies are at higher risk for shoulder dystocia, most cases of shoulder dystocia happen in smaller babies because there are many more small and normal-size babies being born than large babies.[13] LGA babies are at higher risk of low blood sugar (hypoglycemia) in the neonatal period, independent of whether the mother has diabetes.[14] Hypoglycemia, as well as hyperbilirubinemia and polycythemia, occurs as a result of hyperinsulinemia in the fetus.[15] High birth weight may also impact the baby in the long term, as studies have shown associations with increased risk of overweight, obesity, and type 2 diabetes mellitus.[4][16][17] Studies have shown that the long-term overweight risk is doubled when the birth weight is greater than 4,000 g. The risk of type 2 diabetes mellitus as an adult is 19% higher in babies weighing more than 4,500 g at birth compared to those with birth weights between 4,000 g and 4,500 g.[18] Pregnant mother complications Complications of the pregnant mother include: emergency cesarean section, postpartum hemorrhage, and obstetric anal sphincter injury.[7] Compared to pregnancies without macrosomia, pregnant women giving birth to newborns weighing between 4,000 grams and 4,500 grams are at twice the risk of complications, and those giving birth to infants over 4,500 grams are at three times greater risk.[7] Causes Multiple factors have been shown to increase the likelihood of infant macrosomia, including preexisting obesity, diabetes, or dyslipidemia of the mother, gestational diabetes, post-term pregnancy, prior history of a macrosomic birth, genetics, and other factors.[4] Risk factors Diabetes of the mother One of the primary risk factors of LGA births and macrosomia is poorly-controlled maternal diabetes, particularly gestational diabetes (GD), as well as preexisting type 2 diabetes mellitus (DM).[19] The risk of having a macrosomic fetus is three times greater in mothers with diabetes than those without diabetes.[20] Obesity in the mother Obesity before pregnancy and maternal weight gain above recommended guidelines during pregnancy are other key risk factors for macrosomia or LGA infants.[21][22][23] It has been demonstrated that while maternal obesity and gestational diabetes are independent risk factors for LGA and macrosomia, they can act synergistically, with even higher risk of macrosomia when both are present.[4][20] Genetics Genetics can also play a role in having an LGA baby, and it is seen that taller, heavier parents tend to have larger babies.[24] Genetic disorders of overgrowth (e.g. Beckwith–Wiedemann syndrome, Sotos syndrome, Perlman syndrome, Simpson-Golabi-Behmel syndrome) are often characterized by macrosomia.[25][26] Other risk factors • Gestational age: pregnancies that go beyond 40 weeks increase the incidence of an LGA infant[20] • Fetal sex: male infants tend to weigh more than female infants[8] • Multiparity: giving birth to previous LGA infants vs. non-LGA infants[8] • Frozen embryo transfer as fertility treatment, as compared with fresh embryo transfer or no artificial assistance[27][28] • Maternal gut microbiome: A correlation has been identified between the maternal gut microbiome and macrosomia in recent research. The occurrence of macrosomia may be influenced by specific gut microbiota, including Bacteroides salyersiae, Bacteroides plebeius, Ruminococcus lactaris, and Bacteroides ovatus.[29] Mechanism How each of these factors leads to excess fetal growth is complex and not completely understood.[4][30] Traditionally, the Pedersen hypothesis has been used to explain the mechanism by which uncontrolled gestational diabetes can lead to macrosomia, and many aspects of it have been confirmed with further studies.[20] This explanation proposes that impaired glucose control in the mother leads to a hyperglycemic state for the fetus, which leads to a hyperinsulinemia response, in turn causing increased glucose metabolism, fat deposition, and excess growth.[20][30][31] It has also been shown that different patterns of excess fetal growth are seen in diabetic associated macrosomia compared to other predisposing factors, suggesting different underlying mechanisms.[4][30] Specifically, macrosomic infants associated with glucose abnormalities are seen to have increased body fat, larger shoulders, and abdominal circumference.[4][30] Maternal Lipid metabolism During pregnancy, the levels of fat (lipids) in a mother's blood can influence how the baby grows. Studies have shown that higher levels of triglyceride and remnant cholesterol early in pregnancy are linked to faster fetal growth and a greater chance of the baby being born larger than average for its gestational age.[32] Later in pregnancy, higher total cholesterol in the mother's blood has also been linked to higher birthweight, supporting the idea that maternal lipid levels can directly affect the baby's growth.[33] Diagnosis Diagnosing fetal macrosomia cannot be performed until after birth, as evaluating a baby's weight in the womb may be inaccurate.[20] While ultrasound has been the primary method for diagnosing LGA, this form of fetal weight assessment remains imprecise, as the fetus is a highly variable structure in regards to density and weight— no matter the gestational age.[20] Ultrasonography involves an algorithm that incorporates biometric measurements of the fetus, such as biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), to calculate the estimated fetal weight (EFW).[34] Variability of fetal weight estimations has been linked to differences due to sensitivity and specificity of ultrasound algorithms as well as to the individual performing the ultrasound examination.[35] In addition to sonography, fetal weight can also be assessed using clinical and maternal methods. Clinical methods for estimating fetal weight involve measuring the mother's symphysis-fundal height and performing Leopold's maneuvers, which can help with determining the fetus's position in utero in addition to size.[35] However, as this method relies heavily on practitioner experience and technique, it does not provide an accurate and definite diagnosis of an LGA infant and would only serve as a potential indication of suspected macrosomia.[35] Fetal weight can also be estimated through a mother's subjective assessment of the fetus's size, but this method is dependent on a mother's experience with past pregnancies and may not be clinically useful.[35] New methods are being studied for their accuracy in predicting fetal weight, such as measuring fetal soft tissue, but more research needs to be done to find a consistent, reliable method.[36]