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The term macrosomia is used to describe a newborn with an excessive birth weight. It can be known only after the child birth and the condition is confirmed only retrospectively, ie, after delivery of the neonate. Fetal macrosomia has been defined in several different ways, including birth weight of 4000-4500 g (8 lb 13 oz to 9 lb 15 oz) or greater than 90% for gestational age after correcting for neonatal sex and ethnicity.
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Macrosomia may be associated with birth trauma for the neonate and birth canal lacerations, eg, perineal, vaginal, and cervical, or cesarean delivery for the mother. However, macrosomia in the neonate of a diabetic mother may indicate poor glucose control. Possible signs and symptoms include: Large fundal height (A fundal height that measures larger than expected could be a sign of fetal macrosomia.) Excessive amniotic fluid (The amount of amniotic fluid reflects your baby's urine output, and a larger baby produces more urine.)
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Variation in the percentage of macrosomia in different ethnic groups has been observed independent of diabetes. In general, Hispanic women have a larger proportion of macrosomic newborns compared with white, African American, or Asian women. Macrosomic neonates are at risk for shoulder dystocia and birth trauma. This risk is directly related to neonatal birth weight and begins to increase substantially when birth weight exceeds 4500 g and particularly when it exceeds 5000 g. Male infants are more likely to be macrosomic than female infants. Macrosomia occurs with higher frequency in newborns of Hispanic origin.