Prediction and prevention of the macrosomic fetus.

Hdl Handle:
http://hdl.handle.net/10147/248821
Title:
Prediction and prevention of the macrosomic fetus.
Authors:
Walsh, Jennifer M; McAuliffe, Fionnuala M
Affiliation:
UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland. jennifer.walsh@ucd.ie
Citation:
Prediction and prevention of the macrosomic fetus. 2012, 162 (2):125-30 Eur. J. Obstet. Gynecol. Reprod. Biol.
Journal:
European journal of obstetrics, gynecology, and reproductive biology
Issue Date:
Jun-2012
URI:
http://hdl.handle.net/10147/248821
DOI:
10.1016/j.ejogrb.2012.03.005
PubMed ID:
22459652
Abstract:
Fetal macrosomia is associated with significant maternal and neonatal morbidity. In the long term, infants who are large for gestational age are more likely than other infants to be obese in childhood, adolescence and early adulthood, and are inherently at higher risk of cardiovascular and metabolic complications in adulthood. With over one billion adults in the world now overweight and more than 600 million clinically obese, preventing the vicious cycle effect of fetal macrosomia and childhood obesity is an increasingly pertinent issue. Fetal growth is determined by a complex interplay of various genetic and environmental influences. Consequently the prediction of pregnancies at risk of pathological overgrowth is difficult. Many risk factors for fetal macrosomia, such as maternal obesity and advanced maternal age, are also conversely associated with intrauterine growth restriction. Sonographic detection of fetal macrosomia is notoriously fraught with difficulties, with dozens of formulas for estimated fetal weight proposed but few with sufficient sensitivity to alter clinical practice. This calls into question policies of elective delivery based on projected estimated fetal weight cut-offs alone. More recently the identification of markers of fetal adiposity and maternal serum biomarkers are being investigated to improve the antenatal detection of the large for gestational age fetus. Prevention of fetal macrosomia is entirely dependent upon correct identification of those at risk. Maternal weight, gestational weight gain and glycaemic control are the risk factors for fetal macrosomia that are most amenable to intervention, and have potential maternal health benefits beyond pregnancy and childbirth. The ideal method of optimising maternal weight and glucose homeostasis is yet to be elucidated, though a number of promising advances are recently being reported. In this review we outline the contemporary evidence for the prediction and prevention of fetal macrosomia, which is indeed a contemporary dilemma.
Item Type:
Article
Language:
en
MeSH:
Biological Markers; Diabetes, Gestational; Diet; Exercise; Female; Fetal Macrosomia; Humans; Predictive Value of Tests; Pregnancy
ISSN:
1872-7654

Full metadata record

DC FieldValue Language
dc.contributor.authorWalsh, Jennifer Men_GB
dc.contributor.authorMcAuliffe, Fionnuala Men_GB
dc.date.accessioned2012-10-15T14:12:18Z-
dc.date.available2012-10-15T14:12:18Z-
dc.date.issued2012-06-
dc.identifier.citationPrediction and prevention of the macrosomic fetus. 2012, 162 (2):125-30 Eur. J. Obstet. Gynecol. Reprod. Biol.en_GB
dc.identifier.issn1872-7654-
dc.identifier.pmid22459652-
dc.identifier.doi10.1016/j.ejogrb.2012.03.005-
dc.identifier.urihttp://hdl.handle.net/10147/248821-
dc.description.abstractFetal macrosomia is associated with significant maternal and neonatal morbidity. In the long term, infants who are large for gestational age are more likely than other infants to be obese in childhood, adolescence and early adulthood, and are inherently at higher risk of cardiovascular and metabolic complications in adulthood. With over one billion adults in the world now overweight and more than 600 million clinically obese, preventing the vicious cycle effect of fetal macrosomia and childhood obesity is an increasingly pertinent issue. Fetal growth is determined by a complex interplay of various genetic and environmental influences. Consequently the prediction of pregnancies at risk of pathological overgrowth is difficult. Many risk factors for fetal macrosomia, such as maternal obesity and advanced maternal age, are also conversely associated with intrauterine growth restriction. Sonographic detection of fetal macrosomia is notoriously fraught with difficulties, with dozens of formulas for estimated fetal weight proposed but few with sufficient sensitivity to alter clinical practice. This calls into question policies of elective delivery based on projected estimated fetal weight cut-offs alone. More recently the identification of markers of fetal adiposity and maternal serum biomarkers are being investigated to improve the antenatal detection of the large for gestational age fetus. Prevention of fetal macrosomia is entirely dependent upon correct identification of those at risk. Maternal weight, gestational weight gain and glycaemic control are the risk factors for fetal macrosomia that are most amenable to intervention, and have potential maternal health benefits beyond pregnancy and childbirth. The ideal method of optimising maternal weight and glucose homeostasis is yet to be elucidated, though a number of promising advances are recently being reported. In this review we outline the contemporary evidence for the prediction and prevention of fetal macrosomia, which is indeed a contemporary dilemma.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to European journal of obstetrics, gynecology, and reproductive biologyen_GB
dc.subject.meshBiological Markers-
dc.subject.meshDiabetes, Gestational-
dc.subject.meshDiet-
dc.subject.meshExercise-
dc.subject.meshFemale-
dc.subject.meshFetal Macrosomia-
dc.subject.meshHumans-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshPregnancy-
dc.titlePrediction and prevention of the macrosomic fetus.en_GB
dc.typeArticleen
dc.contributor.departmentUCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland. jennifer.walsh@ucd.ieen_GB
dc.identifier.journalEuropean journal of obstetrics, gynecology, and reproductive biologyen_GB
dc.description.provinceLeinsteren

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