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Macrosomia
Anne Kennedy, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Large for gestational age (LGA)
            • Definitions

              • Birth weight (BW) > 4,000 g or 4,500 g (or 10 lb); American College of Obstetrics and Gynecology (ACOG) supports > 4,500 g as morbidity sharply ↑ beyond this weight
              • LGA: Estimated fetal weight (EFW) or BW > 90th percentile
              • No international standard established
                • Country-specific population percentiles would be best

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Reporting Tips

                                    Selected References

                                    1. Duncan JR et al: Prediction of large for gestational age neonates by different growth standards. J Ultrasound Med. 40(5):963-70, 2021
                                    2. Bicocca MJ et al: Identification of newborns with birthweight ≥ 4,500g: ultrasound within one- vs. two weeks of delivery. Eur J Obstet Gynecol Reprod Biol. 249:47-53, 2020
                                    3. Committee on Practice Bulletins—Obstetrics.: Macrosomia: ACOG practice bulletin, number 216. Obstet Gynecol. 135(1):e18-35, 2020
                                    4. Robinson R et al: The test accuracy of antenatal ultrasound definitions of fetal macrosomia to predict birth injury: a systematic review. Eur J Obstet Gynecol Reprod Biol. 246:79-85, 2020
                                    5. Salihu HM et al: Trends in the incidence of fetal macrosomia and its phenotypes in the United States, 1971-2017. Arch Gynecol Obstet. 301(2):415-26, 2020
                                    6. Beta J et al: Maternal and neonatal complications of fetal macrosomia: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 54(3):308-18, 2019
                                    7. Fang F et al: Risk factors for recurrent macrosomia and child outcomes. World J Pediatr. 15(3):289-96, 2019
                                    8. Khan N et al: Prediction of large-for-gestational-age neonate by routine third-trimester ultrasound. Ultrasound Obstet Gynecol. 54(3):326-33, 2019
                                    9. Wastlund D et al: The cost-effectiveness of universal late-pregnancy screening for macrosomia in nulliparous women: a decision analysis. BJOG. 126(10):1243-50, 2019
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Synonyms

                                                • Large for gestational age (LGA)
                                              • Definitions

                                                • Birth weight (BW) > 4,000 g or 4,500 g (or 10 lb); American College of Obstetrics and Gynecology (ACOG) supports > 4,500 g as morbidity sharply ↑ beyond this weight
                                                • LGA: Estimated fetal weight (EFW) or BW > 90th percentile
                                                • No international standard established
                                                  • Country-specific population percentiles would be best

                                              IMAGING

                                              • General Features

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Staging, Grading, & Classification

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Duncan JR et al: Prediction of large for gestational age neonates by different growth standards. J Ultrasound Med. 40(5):963-70, 2021
                                                                      2. Bicocca MJ et al: Identification of newborns with birthweight ≥ 4,500g: ultrasound within one- vs. two weeks of delivery. Eur J Obstet Gynecol Reprod Biol. 249:47-53, 2020
                                                                      3. Committee on Practice Bulletins—Obstetrics.: Macrosomia: ACOG practice bulletin, number 216. Obstet Gynecol. 135(1):e18-35, 2020
                                                                      4. Robinson R et al: The test accuracy of antenatal ultrasound definitions of fetal macrosomia to predict birth injury: a systematic review. Eur J Obstet Gynecol Reprod Biol. 246:79-85, 2020
                                                                      5. Salihu HM et al: Trends in the incidence of fetal macrosomia and its phenotypes in the United States, 1971-2017. Arch Gynecol Obstet. 301(2):415-26, 2020
                                                                      6. Beta J et al: Maternal and neonatal complications of fetal macrosomia: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 54(3):308-18, 2019
                                                                      7. Fang F et al: Risk factors for recurrent macrosomia and child outcomes. World J Pediatr. 15(3):289-96, 2019
                                                                      8. Khan N et al: Prediction of large-for-gestational-age neonate by routine third-trimester ultrasound. Ultrasound Obstet Gynecol. 54(3):326-33, 2019
                                                                      9. Wastlund D et al: The cost-effectiveness of universal late-pregnancy screening for macrosomia in nulliparous women: a decision analysis. BJOG. 126(10):1243-50, 2019