question about baby weight and potential problems?

[GingerSue]

this is case study about a newborn female who weighs 8 lbs and 14 ounces,

at 40 weeks' gestation

and she is sleepy on her first day after birth.

without knowing her mother's or parents' body build, weight, height, etc

what are the potential problems - is she considered to be LGA or macrosomic? (normal range is 5 lbs - 8 lbs 13 ounces, or 2500 g - 4000 g, and macrosomia is greater than 4500 g)

LGA infants - the cause is unclear

- might be multiparous mother, genetic predisposition, male infants typically larger, or infants with erythroblastosis fertalis, Beckwith-Wiedemann syndrome, or transposition of the great vessels

- macrosomic infants have poor motor skills, have more difficulty regulating behavioral state

- LGA infants tend to be more difficult to arouse and may have problems maintaining a quiet alert state and they may have feeding difficulties

LGA complications of the LGA infant

- birth trauma due to CPD, hypoglycemia, polycythemia, and hyperviscosity

So, this infant would have to be considered first of all in terms of the mother's/parent's size.

Is this infant considered LGA?

[Jolie, BSN]

this is case study about a newborn female who weighs 8 lbs and 14 ounces,

at 40 weeks' gestation

and she is sleepy on her first day after birth.

without knowing her mother's or parents' body build, weight, height, etc

what are the potential problems - is she considered to be LGA or macrosomic? (normal range is 5 lbs - 8 lbs 13 ounces, or 2500 g - 4000 g, and macrosomia is greater than 4500 g)

LGA infants - the cause is unclear

- might be multiparous mother, genetic predisposition, male infants typically larger, or infants with erythroblastosis fertalis, Beckwith-Wiedemann syndrome, or transposition of the great vessels

- macrosomic infants have poor motor skills, have more difficulty regulating behavioral state

- LGA infants tend to be more difficult to arouse and may have problems maintaining a quiet alert state and they may have feeding difficulties

LGA complications of the LGA infant

- birth trauma due to CPD, hypoglycemia, polycythemia, and hyperviscosity

So, this infant would have to be considered first of all in terms of the mother's/parent's size.

Is this infant considered LGA?

To determine whether she (or any baby) is LGA, AGA, or SGA you need to convert her weight to grams and plot it on a newborn growth chart, along with her length and head circumference, if available.

Once you determine this, you would do a thorough newborn assessment to determine whether she displays any of the physical or developmental characteristics common to LGA babies. You would also want to assess for any possible complications of LGA such as hypoglycemia, or birth trauma.

[GingerSue]

charts in my book show classification by birth weight and gestational age (weeks), with LGA above the 90th percentile

- at 40 weeks the 90th percentile shows 3750 g

the other classification is based on maturity and intrauterine growth (chart for length, chart for weight, chart for head circumference, chart or weight + length ratio) and again with LGA above the 90th percentile.

I don't have the length or head circumference (so these would be useful to measure as part of the assessment), but without this information, I have only the 40 weeks and the 8 lbs 14 oz (which is just one ounce beyond the "normal" range for weight) - but it would depend partly on the mother's size (and health)

so would it be safe to say that all the potential problems of a LGA baby should be assessed just to be on the safe side (in this hypothetical case)?

the baby's weight of 4029 grams puts her into the LGA section of the weight:weeks chart

[Jolie, BSN]

charts in my book show classification by birth weight and gestational age (weeks), with LGA above the 90th percentile

- at 40 weeks the 90th percentile shows 3750 g

the other classification is based on maturity and intrauterine growth (chart for length, chart for weight, chart for head circumference, chart or weight + length ratio) and again with LGA above the 90th percentile.

I don't have the length or head circumference (so these would be useful to measure as part of the assessment), but without this information, I have only the 40 weeks and the 8 lbs 14 oz (which is just one ounce beyond the "normal" range for weight) - but it would depend partly on the mother's size (and health)

so would it be safe to say that all the potential problems of a LGA baby should be assessed just to be on the safe side (in this hypothetical case)?

the baby's weight of 4029 grams puts her into the LGA section of the weight:weeks chart

You are correct that this baby would be classified as LGA, based on her weight. The mother's size and health do not have any bearing on how you would classify the baby's size in terms of AGA, LGA or SGA. Her large size may be due to genetics, diabetes, or other causes, but those factors do not affect how you classify her. They may influence how you will care for her (for example, an LGA baby will require assessment of blood glucose levels), but not how you clasify her.