Fetal Growth Acceleration-Current Approach to the Big Baby Issue

Area of Science:

• Perinatal Medicine
• Maternal-Fetal Medicine
• Neonatology

Background:

• Fetal overgrowth is associated with significant perinatal complications like stillbirth, cesarean delivery, and shoulder dystocia.
• Risk factors include maternal diabetes, obesity, and excessive gestational weight gain, but it also occurs in low-risk pregnancies.
• Current definitions and detection methods for fetal overgrowth are debated, impacting risk stratification.

Purpose of the Study:

• To review the evidence linking fetal overgrowth to adverse perinatal outcomes.
• To discuss the role of detection methods in identifying at-risk pregnancies.
• To propose a new classification for fetal overgrowth.

Main Methods:

• A narrative review of existing literature.
• PubMed search using terms like 'macrosomia' and 'large-for-gestational-age' combined with outcomes of interest.
• Synthesis of evidence on fetal overgrowth and its associated complications.

Main Results:

• Fetal overgrowth is associated with stillbirth, cesarean sections, shoulder dystocia, anal sphincter injury, and hemorrhage.
• Customized growth charts aid in identifying fetuses and mothers at risk for these complications.
• The relationship between fetal overgrowth and maternal factors like diabetes, weight, and gestational weight gain was examined.

Conclusions:

• A significant portion of perinatal complications result from excessive fetal growth.
• Fetal overgrowth should be recognized as a distinct and dangerous condition, termed Fetal Growth Acceleration.
• Improved detection and classification are crucial for managing pregnancies with fetal overgrowth.