Overview

Large for gestational age (LGA) refers to a neonate born with a birth weight exceeding 90th centile for gestational age.

• Prenatal diagnosis of LGA neonates
  • Fundal height measurement more than expected for weeks of pregnancy
  • Ultrasonography can be used to estimate fetal weight and size
• Postnatal diagnosis of LGA neonates
  • Assessing weight, length and head circumference

Risk factors

• Constitutional – parents are also large
• Maternal diabetes
• Maternal obesity
• Maternal history of delivering LGA infants
• Foetal hyperinsulinism – pancreatic islet cell hyperplasia.
• Hydrops foetalis – condition in the foetus characterised by fluid accumulation
• Beckwith–Wiedemann syndrome – congenital overgrowth syndrome

Complications

• Birth injuries – brachial plexus injuries and fractures
• Difficult delivery
• Birth asphyxia
• Meconium aspiration
• Hypoglycemia
• Increased risk of birth defects – children born to diabetic mothers are at increased risk of developing birth defects such as caudal regression syndrome
• Polycythemia
• Delayed lung development predisposing neonate to RDS, TTN

Treatment is according to complications met.