QuestionI have a couple of questions for you, please and thank you. I'm 35 weeks pregnant, and my OB is telling me that my baby is measuring around 38.5 weeks gestation. In another 10 days, I go for a Level 2 ultrasound to get more exact weight and height measurements. At the moment, she is determining he could be around 11 pounds at 40 weeks! Yikes!
First question - What constitutes growing such a large baby in utero? Is it genetics? Is it something else? I'm a petite person, but have gained 50 pounds this pregnancy to date. I do not have gestational diabetes (my glucose level after the one hour test was 77). I do, however, eat A LOT! I consume three large meals a day, plus I find myself constantly hungry, so I'm always grazing. Wouldn't surprise me if I eat over 3000 calories per day - from good foods like grains, veggies, lots of fruit, and protein (plus my prenatals), but I also have a sweet tooth and do enjoy candy and breads daily. I find if I don't eat while hungry, I get very nauseated. Could the baby's large size be related to my diet as well?
Second question - What does giving birth to a large baby mean? I don't care if he's born vaginally or via C-Section, I just want it to be the safest method for him. I'm just wondering, if the baby is using my fat storage for his own, does this mean he could be born hypoclycemic? And if so, how are hypoglycemic babies treated? What is their prognois?
Thanks for your attention. I'm starting to wind down this pregnancy and getting nervous about birth!
AnswerMacrosomia (excessively large baby) in utero can certainly be due to genetic or familial causes. It can be due to Diabetes, but with a 1hGTT of 77 Diabetes is unlikely. You really should not eat more than 2100 calories per day and should not gain more than 4 pounds per visit. A weight gain of 50 pounds is not good.
The American College of Obstetrics and Gynecology recommends that, if the estimated fetal weight (EFW) on sonogram, at term (39-40 weeks) is greater than 9 pounds, a cesarean section should be done to deliver the baby. This avoids the risk of shoulder dystocia and the possibility of neurologic damage to the baby. If a sonogram confirms the macrosomia and the EFW is over 9 lbs, I would recommend that you have a cesarean section. I would suggest that you have the sonogram now and, if it confirms the macrosomia, have the cesarean section right away.
Your blood is the same as the baby. If your blood sugar is high, your pancreas produces more insulin to control your blood glucose. The baby's pancreas also works very hard to control its blood glucose. When the baby is born, the pancreas continues to work hard and, since there is no longer lots of glucose coming into its blood stream due to y our eating, there is a drop in the amount of glucose in the baby and it can become hypoglycemic. If so, it would be treated with glucose and IV therapies. However, you do not have gestational diabetes, so it is unlikely that the baby will be hypoglycemic.
