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Does Gestational Diabetes Mean Big Baby

Large For Gestational Age (lga)

Large For Gestational Age (lga)

What is LGA? Large for gestational age is a term used to describe babies who are born weighing more than the usual amount for the number of weeks of pregnancy. LGA babies have birthweights greater than the 90th percentile for their gestational age, meaning that they weigh more than 90 percent of all babies of the same gestational age. The average baby weighs about 7 pounds at birth. About 9 percent of all babies weigh more than 4,000 grams (8 pounds, 13 ounces). Rarely do babies weigh over 10 pounds. Although most LGA babies are born at term (37 to 41 weeks of pregnancy), a few premature babies may be LGA. What causes LGA? Some babies are large because their parents are large; genetics does play a part. Birthweight may also be related to the amount of weight a mother gains during pregnancy. Excessive weight gain can translate to increased fetal weight. By far, maternal diabetes is the most common cause of LGA babies. Diabetes during pregnancy causes the mother's increased blood glucose (sugar) to circulate to the baby. In response, the baby's body makes insulin. All the extra sugar and the extra insulin production can lead to excessive growth and deposits of fat, thus, a larger baby. Why is LGA a concern? Because LGA babies are so large, delivery can be difficult. Delivery problems may include the following: Prolonged vaginal delivery time Difficult birth Birth injury Increased risk of cesarean delivery Because many large babies are born to diabetic mothers, many problems of LGA babies are related to problems with glucose regulation. These may include the following: Hypoglycemia (low blood sugar) of baby after delivery Increased incidence of birth defects Respiratory distress (difficulty breathing) Many babies with LGA also have hyperbilirubinemia (jaundice or yellowing Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes mellitus (GDM) is a condition of abnormally raised blood sugar levels that may occur in the second part of the pregnancy and goes away once the baby is born. Some women with gestational diabetes may need no treatment, some need a strict diet and others may need insulin injections. As GDM is a condition that occurs during pregnancy, it is not the same as having pre-existing diabetes during your pregnancy. Between 5% and 10% of pregnant women develop gestational diabetes, usually around the 24th to 28th week of pregnancy. Typically, women with gestational diabetes have no symptoms. Most women are diagnosed after special blood tests Some women with gestational diabetes (about 30%) have larger than average babies. As a result, they are more likely to have intervention in labour such as a caesarean birth. But the baby will not be born with diabetes. Studies have suggested that women who develop gestational diabetes have an increased risk of developing type 2 diabetes later in life. Testing for gestational diabetes All women are screened for gestational diabetes at their 24 to 28 week routine check up. Women who are at higher risk may be tested more often. You are at higher risk of developing gestational diabetes if you: are overweight over the age of 25 years a family history of type 2 diabetes come from an Aboriginal and Torres Strait Islander or some Asian backgrounds have had gestational diabetes before have had a large baby before. The tests available for gestational diabetes are: Glucose challenge test There is no fasting required and you are given a 50g glucose drink (equivalent to 10 teaspoons of sugar) with a blood test taken one hour after. This is a screening test only and if the result is above a certain level, you will be advised to have a gl Continue reading >>

I'm Having A Giant Baby: No More Fruit Salad?

I'm Having A Giant Baby: No More Fruit Salad?

Aware of the risks of gestational diabetes, Roma Kojima talks to her OB/GYN about food choices...but when did fruit become the enemy? Roma Kojima is a soon-to-be mom of a tiny, wriggly girl. Aside from growing a human, she works in business development at Rogers Media, loves to travel and cook, and obsesses about leather purses she can’t afford. Follow along as she shares her pregnancy journey. At 35 weeks now and in the throes of what everyone helpfully calls The Home Stretch. I feel neither at home in my body, nor stretchy. Mostly I feel overcrowded, grumpy and in pain whenever this kid kicks me in the junk from the inside. But whatever, one month (ish) to go. Read more: Is birth weight related to ethnicity? I had my 32-week ultrasound recently. Much fun was had by all, especially when this little diva decided she wasn’t going to entertain any pictures and insisted on covering her face with her hands the entire time. They took all her measurements anyway and off I waddled to see a doctor. The doctor, not my regular OB/GYN, informed me quite enthusiastically that I was having a “Giant Baby.” “What’s a Giant Baby?” I asked nervously. “Oh, your baby is within the 94th percentile in size—we measure the size of the head (ouch says future-me), abdomen and femur. By our estimates, the average weight at this point should be around 3.75 lbs. Yours is around 5.4 lbs.” I looked at my five-foot, four-inch-tall husband and I looked at myself—a towering five-foot-three. “Maybe she’s adopted?” Jokes aside, I would much rather she be bigger than too small. “But wait,” the paranoid side of my brain said. “Doesn’t a bigger fetus often mean gestational diabetes?” I have a family history of diabetes and my mother suffered from GD during more than one Continue reading >>

Conversations

Conversations

Add another line to the long list of medical problems associated with obesity: A new study finds that women who are overweight during pregnancy tend to have much heavier babies than normal-weight moms. “If the baby is born too large it increases the risk for very serious consequences both during delivery, for the mother and the infant, as well as later in life — for the infant,” said study author Mary Helen Black, a biostatistician with Kaiser Permanente Southern California’s department of research and evaluation. “There may be a general perception that, ‘Oh, the baby’s big, but so what?’ That’s a misperception.” In the new study, published in the journal Diabetes Care on Tuesday, Black and her colleagues examined health records for more than 9,800 women who delivered their babies at a Kaiser Permanente medical center in California between 2005 and 2010. About 60 percent of the women were overweight or obese, and nearly 20 percent developed gestational diabetes. Compared to healthy-weight women, overweight moms without gestational diabetes were 65 percent more likely to have babies with a birth weight in the 90th percentile or higher. (Women were defined as overweight if they had a body mass index — a measure of height relative to weight — of 25 to 30. They were obese if they had a body mass index of 30 or more.) Obese women without gestational diabetes were 163 percent more likely to have overly large babies. Because researchers relied on electronic health records for the study, they did not directly measure babies’ bodies. But Black said most of the overly large infants were not just tall, and thus proportional to their height. Instead, they probably had too much fat, she said. Notably, the chances of having a big baby increased regardless of Continue reading >>

Large For Gestational Age

Large For Gestational Age

Large for gestational age (LGA) is an indication of high prenatal growth rate. LGA is often defined as a weight, length, or head circumference that lies above the 90th percentile for that gestational age.[1] However, it has been suggested that the definition be restricted to infants with birth weights greater than the 97th percentile (2 standard deviations above the mean) as this more accurately describes infants who are at greatest risk for perinatal morbidity and mortality.[2][3] Macrosomia, which literally means "long body", is sometimes confused with LGA. Some experts consider a baby to be big when it weighs more than 8 pounds 13 ounces (4,000 g) at birth, and others say a baby is big if it weighs more than 9 pounds 15 ounces (4,500 g).[4] A baby is also called “large for gestational age” if its weight is greater than the 90th percentile at birth.[5] Diagnosis[edit] LGA and macrosomia cannot be diagnosed until after birth, as it is impossible to accurately estimate the size and weight of a child in the womb.[4] Babies that are large for gestational age throughout the pregnancy may be suspected because of an ultrasound, but fetal weight estimations in pregnancy are quite imprecise.[4] For non-diabetic women, ultrasounds and care providers are equally inaccurate at predicting whether or not a baby will be big. If an ultrasound or a care provider predicts a big baby, they will be wrong half the time.[4] Although big babies are born to only 1 out of 10 women,[citation needed] the 2013 Listening to Mothers Survey found that 1 out of 3 American women were told that their babies were too big.[6] In the end,[clarification needed] the average birth weight of these suspected “big babies” was only 7 pounds 13 ounces (3,500 g).[7] In the end,[clarification needed] care Continue reading >>

Mom's Weight, Not Blood Sugar Levels, May Lead To Birth Of Large Baby

Mom's Weight, Not Blood Sugar Levels, May Lead To Birth Of Large Baby

(CBS News) A mother's weight before and during pregnancy may be more of an indicator that she will give birth to a big baby than her blood glucose levels, new research reveals. According to the study, slightly high blood glucose levels -- not enough to diagnose the mother with gestational diabetes according to Canadian standards -- had no association with having a larger bundle of joy once weight was taken into an account. The new study, published in the May 22 issue of the Canadian Medical Association Journal, contradicts some current thoughts on why babies are born overweight. Many experts believe that gestational diabetes is the most common cause of macrosomia, the name for when a fetus is "abnormally large" and weighs 8 pounds, 13 ounces or more at birth, according to the NYU Langone Medical Center. For the purposes of the study, a large baby was defined as one who placed in the 90th percentile for his or her race, size and weight according to gestational age. The ADA recently lowered its blood sugar level threshold for gestational diabetes because it said previous standards only accounted for women's risk of developing diabetes in the future and didn't include risks to the mother or baby, including a overly heavy birth weight, according to Science Daily. According to a Feb. 2010 report in Diabetes Care - a journal of the American Diabetes Association - mothers who had gestational diabetes according to the lower standards had a 50 percent chance of having an overweight baby. They estimate that 18 percent of expecting mothers have disease according to the lower threshold. However, the U.S. and Canada have not adopted the ADA's levels yet, and the American College of Obstetricians and Gynecologists is holding off on their decision until a conference in October 2012 on Continue reading >>

Macrosomia (big Baby)

Macrosomia (big Baby)

How big is a big baby? The average newborn weighs about 3.4kg (7lb 8oz). Babies weighing more than 4kg (8lb 13oz) at birth are considered larger than average, or macrosomic. If you have a very large baby, weighing 4.5kg (9lb 15oz) or more, it can put you and your baby at greater risk of certain complications. Although many women give birth to very big babies without any problems, it's common to need a bit of help. About 11 per cent of babies in England are born at a weight of 4kg or more, with 1.6 per cent weighing 4.5kg or more. How will I know if I'm having a big baby? It's very difficult to determine whether your baby is truly macrosomic while he's still in the womb. Only his post-birth weight confirms this. Your midwife or GP may suspect your baby will be big if you're measuring large for dates. An ultrasound scan can give an idea of how big your baby really is. However, bear in mind this is not always accurate in later pregnancy. There can be a difference of about 10 per cent between your baby's weight predicted by ultrasound, and his actual weight at birth. If the scan shows that your baby is large for dates, your midwife may want to monitor your blood sugar levels. This is to see if you are developing gestational diabetes. What might cause my baby to be large? Probably the most influential factor is gestational diabetes or pre-existing diabetes. You are also more likely to have a large baby if: You have a high body mass index (BMI) at the start of your pregnancy. You've gained a lot of weight during pregnancy. You go more than two weeks past your due date. You've gained a lot of weight between pregnancies or not lost weight from a previous pregnancy. Ethnicity has a part to play and even your baby's sex can make a difference, as boys are more often larger than gi Continue reading >>

Gestational Diabetes

Gestational Diabetes

Overview Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health. Any pregnancy complication is concerning, but there's good news. Expectant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and keep you and your baby healthy. In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for type 2 diabetes. You'll continue working with your health care team to monitor and manage your blood sugar. Symptoms For most women, gestational diabetes doesn't cause noticeable signs or symptoms. When to see a doctor If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you're pregnant, your doctor will check you for gestational diabetes as part of your prenatal care. If you develop gestational diabetes, you may need more-frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will monitor your blood sugar level and your baby's health. Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy. To make sure your blood sugar level has returned to normal after your baby is born, your health care team wil Continue reading >>

Does Gestational Diabetes Always Mean A Big Baby And Induction?

Does Gestational Diabetes Always Mean A Big Baby And Induction?

July 3, 2012 by Rebecca Dekker, PhD, RN, APRN © Copyright Evidence Based Birth®. Please see disclaimer and terms of use. This question was submitted to me by one of my readers, Sarah. “I have a question about gestational diabetes. It seems like everyone I know who has had it has ended up being induced. Does gestational diabetes automatically mean induction? Does it automatically mean big babies? It seems like people get diagnosed and then give up on a natural childbirth and are treated as a sick person.” I talked to Dr. Shannon (a family medicine physician), and she echoed Sarah’s perceptions about gestational diabetes: “I would say that ‘routine care’ in the U.S. is to induce at 38 to 39 weeks for gestational diabetes (leaning towards 39 weeks nowadays) if the mom’s glucose is uncontrolled or if she is controlled on medication. However, women can technically be treated as ‘normal’ if their gestational diabetes is well controlled and baby’s growth looks normal on a 32 week scan. So people just might want to know they will get major push back from their provider if they refuse induction. It’s tough. Many OB’s cite the risk of stillbirth as a reason for induction, because the risk of stillbirth in women with regular diabetes is higher. However, there is no evidence that the risk of stillbirth goes up in gestational diabetes.” Evidence Based Birth® offers an online course on Big Babies and Gestational Diabetes (3 contact hours)! To learn more, click here! Dr. Shannon brings up several good points. First, she is talking about “routine care,” which is very different from “evidence-based care.” Routine care means that this is what everyone is doing—it’s routine, it’s standard. Evidence-based maternity care means offering care that is Continue reading >>

> What Is Gestational Diabetes?

> What Is Gestational Diabetes?

I’m not diabetic, but my doctor told me that I have gestational diabetes. What does that mean? And will it last beyond my pregnancy? – Trish Gestational diabetes is a kind of diabetes that comes on during pregnancy. When a woman has it, the sugar levels in her blood are high. That makes the unborn baby's blood sugar levels go higher, too. A big worry about gestational diabetes is what it can do to a baby. Babies born to mothers who have gestational diabetes are more likely to: grow very large have breathing problems have low blood levels of calcium or glucose just after they're born These and other kinds of problems from gestational diabetes can make babies need to stay in the hospital longer for extra treatment. If you have gestational diabetes, your doctor will probably start you on a treatment plan. Most women can get their blood sugar levels under control with a healthy food plan and daily exercise. Some women also need to take daily insulin shots and test their blood sugar until they give birth. Gestational diabetes usually goes away after a baby is born. A mom may get it again during future pregnancies, though. Some women who have it will get diabetes when they're older. Sometimes a woman may have had diabetes before the pregnancy but not know it. When that happens, the diabetes does not go away after the baby is born. Continue reading >>

The Truth About Gestational Diabetes {and Why It’s Not Your Fault!}

The Truth About Gestational Diabetes {and Why It’s Not Your Fault!}

So you’ve had the Glucose Tolerance Test, or maybe you’ve been monitoring you’re blood sugar levels at home, and your blood sugar readings were high. You have been given a diagnosis of Gestational Diabetes. If your experience was anything like mine, an Obstetrician or midwife gave you a pamphlet on ‘Diabetes and Pregnancy’, referred you to a dietician and endocrinologist for management, and then sent on your way. And now you’re at home, and all the questions you didn’t think to ask are flooding in… What the heck is it? And what does it mean? Will my baby be alright? Do I need a caesarean? Will I need to be on insulin? What can I eat? Do I have to stop eating CHOCOLATE?!?!?! There is some debate against the use of routine testing to diagnose Gestational Diabetes, and also questioning about giving the diagnosis of Gestational Diabetes as a label on pregnant women. Dr. Sarah Buckley recommends avoiding routine testing for Gestational Diabetes for most women. Henci Goer and Dr Michael Odent are among many pregnancy and childbirth professionals who argue against diagnosing women with gestational diabetes, citing unnecessary stress and interventions as one of the risks of the Gestational Diabetes diagnosis. Nevertheless, whether you want to call it Gestational Diabetes or Pregnancy-Induced Insulin Resistance, or just high blood sugar levels in pregnancy, some women do have elevated blood sugar levels and need some extra help. Gestational Diabetes Mellitus (GDM or GD) is described as a form of diabetes that develops during pregnancy, and usually goes away 4-6 weeks postpartum. In a pregnant woman without Gestational Diabetes, the body works ‘as usual’. You eat, your stomach breaks down your food, you start to digest it, and the glucose from the carbohydrate Continue reading >>

Gestational Diabetes And Your Baby's Health

Gestational Diabetes And Your Baby's Health

Insulin, a hormone produced by your pancreas, is necessary to move glucose (or sugar) into your cells after your body breaks down food for energy. During pregnancy, your body becomes less sensitive to the effects of insulin, which can lead to what’s known as gestational diabetes. If you have gestational diabetes, your blood sugar can become too high, creating a number of health risks for your baby. Gestational Diabetes and Your Baby's Health If your blood sugar remains consistently elevated during pregnancy, the excess sugar can pass through your womb to your unborn baby. This can increase your child’s future risk of obesity and type 2 diabetes. Other health risks associated with gestational diabetes include: Macrosomia. This term simply means "big baby" and applies to any baby whose birth weight is above 8 pounds, 13 ounces. A baby with macrosomia can experience difficulties during the childbirth process. The most common problem that big babies encounter is damage to the nerves and muscles in their shoulders during vaginal delivery. Your doctor will monitor the size of your baby by performing ultrasound exams throughout your pregnancy. If your doctor is concerned about the size of your baby, a Caesarean section may be recommended. Hypoglycemia. If your unborn baby is exposed to high blood sugar levels while in the womb, the baby will eventually make extra insulin on its own to deal with the excess sugar. This surge in insulin can cause the baby's glucose to drop sharply right after birth, a condition called "hypoglycemia." Low blood sugar is dangerous because your baby depends almost exclusively on glucose for energy at the time of birth. Signs and symptoms of hypoglycemia include seizures, sluggishness, and difficulty breathing. For this reason, doctors will check Continue reading >>

How Gestational Diabetes Affects You & Your Baby

How Gestational Diabetes Affects You & Your Baby

When you're pregnant, hormone changes can make your blood sugar level rise. Gestational diabetes will raise the odds of pregnancy complications. After you're diagnosed, your doctor or midwife will want to watch your health and your baby's health closely for the rest of your pregnancy. Most women with gestational diabetes have healthy pregnancies and healthy babies. Getting good treatment makes all the difference. How Will It Affect My Baby? Your higher blood sugar affects your baby, too, since they gets nutrients from your blood. Your baby stores that extra sugar as fat, which can make them grow larger than normal. They're more likely to have certain complications: Injuries during delivery because of their size Low blood sugar and mineral levels when they're born Jaundice, a treatable condition that makes the skin yellowish Pre-term birth Later in life, your baby might have a greater chance of obesity and diabetes. So help your child live a healthy lifestyle -- it can lower their odds for these problems. How Will It Affect Me? You might have: A higher chance of needing a C-section Pre-term birth Your blood sugar will probably return to normal after you give birth. But you'll have a higher risk of developing type 2 diabetes later or gestational diabetes again with another pregnancy. A healthy lifestyle can lower the odds of that happening. Just as you can help your child, you can lower your own chances of obesity and diabetes. Although you may need a C-section, many women with gestational diabetes have regular vaginal births. Talk to your doctor or midwife about your delivery options: Does my baby need to be delivered by C-section? How accurate are birth-weight estimates? Could my baby be smaller than you think? What are the risks to my baby and I if I don’t have a C-s Continue reading >>

Why Big Is Not Always Beautiful When It Comes To Babies

Why Big Is Not Always Beautiful When It Comes To Babies

On Thursday, the largest ever baby born naturally in Spain was delivered of a British mother, Maxine Marin who – in a footnote that I will never stop finding annoying – was said not even to need an epidural. Baby Maria, at a massive 6.1kg (13lb 7oz), is said to be in perfect health. She is a beautiful thing, with one of those wise-baby faces and a full head of hair; she looks about six months old. This comes exactly a week after the appearance of the heaviest baby – Jasleen – ever to be born in Germany. Her mother had untreated gestational diabetes, which leads to large babies, so the baby's condition isn't so good, though nor is it life-threatening. While two swallows don't make a summer, and two giant babies do not confirm a giant baby trend, obstetricians nevertheless detect an upward curve. Daghni Rajasingam, consultant obstetrician and Royal College of Obstetricians and Gynaecologists spokeswoman, says: "We are having, on average, larger babies being born. There are several reasons for it, the biggest of which is the global epidemic of obesity and diabetes. If you're obese you have a higher risk of having a large baby anyway, even if you don't have diabetes. "This idea of having a bonnie baby, and that being a good thing, is an old wives' tale. Babies who are born bigger have a higher risk themselves of being obese, developing diabetes and heart problems. You want an appropriate-sized baby, is the thing." What's appropriate? What's normal? What's macrosomic (or, if you prefer, "large")? The numbers have come down a bit – you're now screened for gestational diabetes if you've had a previous birth of 4kg, or 8lb 13oz (it used to be 4.5kg). But the key issue for people with near-hand experience of a large baby is probably not the threshold of what constitute Continue reading >>

Healthy Diet Prevents Birth Of Big Babies

Healthy Diet Prevents Birth Of Big Babies

Research shows women with gestational diabetes who control it with a healthy diet without insulin are at no greater risk of giving birth to a big baby. A healthy diet alone can control gestational diabetes and doesn't put the mother at greater risk of having a big baby, an Australian study has found. Dr Fatima Vally led the study at the Royal Women's Hospital and says the "exciting" findings - published in the Journal of Pregnancy - should provide reassurance to the one in 10 pregnant women who will develop diabetes during their pregnancy. "For women who control their diabetes with diet, we found that they didn't have bigger babies compared to women without the condition," said Dr Vally. Women with gestational diabetes can face an up to 50 per cent increased risk of having a large baby, which can cause serious complications such as injury to the baby and mother during delivery. "We know big babies may have a greater tendency to get stuck in labour which can cause injury to both the baby and mother, so it's a really important outcome to look at," Dr Vally said. Babies can also face a higher risk of low blood sugar levels and needing special treatment after birth. However, a study involving 202 women with gestational diabetes conducted at the Royal Women's Hospital has shown with adequate dietary advice and regular blood glucose monitoring those risks are minimised. On average, these women gave birth to slightly smaller babies compared to healthy pregnant women in the control group. "There is strong evidence of relatively small mean differences in birth weight and EGA (estimated gestational age) with and without gestational diabetes," the authors wrote. Dr Vally says the results, potentially, mean less hospital visits during pregnancy for women with gestational diabetes. Continue reading >>

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