LGA

Question 1

What is the definition of LGA?

Answer 1

BW > 90th centile

Question 2

What is the definition of macrosomia?

Answer 2

BW >4000g

Excessive intrauterine growth beyond a specific threshold, regardless of gestational age

Question 3

What are the risk factors for LGA?

Answer 3

• Ethnicity: Samoan, white
• Genetic syndrome
• Maternal diabetes, especially poorly controlled
• Maternal pre-preg weight
• Excessive GWG
• Multiparity
• AMA
• Post-dates
• Male
• Previous LGA
• Maternal BW > 4000g

Question 4

What are the maternal complications of LGA?

Answer 4

Prolonged labour
Operative vaginal delivery
Caesarean section
Perineal trauma
PPH
Uterine rupture

Question 5

What are the fetal complications of LGA?

Answer 5

Shoulder dystocia leading to birth trauma, brachial plexus injury

Stillbirth. Fetuses >5000g particularly high risk

Question 6

What are the neonatal complications of LGA?

Answer 6

Hypoglycaemia
Respiratory problems
Polycythemia
Minor congenital anomalies
NICU admission (can be prolonged)

Question 7

What are the implications of LGA on childhood and beyond?

Answer 7

Obesity
Impaired glucose tolerance
Metabolic syndrome
Cardiac remodelling