Having a big fat, adorable baby is the dream of many mothers. But while we often hear about the health risks that babies face when they are born too small, large babies are not always healthy. Overweight babies face health complications that are as dangerous as premature children.
What is the weight of a baby at birth that is considered normal?
The weight of a newborn is said to be normal when the numbers on the scale are in the range of 2.5 kilograms to 4 kilograms, especially for babies born quite old (gestational age 37-40 weeks).
In contrast to premature babies - babies born less than 37 weeks who usually weigh less than 2.5 kilograms - babies can be said to be large or have excess weight if the numbers on the scale reach more than 4 kilograms. This baby is usually called a big baby or giant baby. In the medical world, newborns weighing more than 4 kilograms are called macrosomia.
The two examples above are only a small part of the trend of infant birth weights that are increasing globally. The birth rate of very high birth weight babies has increased by as much as 15-25 percent in the last 2-3 decades in many different populations throughout the world. In the United States, it is estimated that ten percent of newborns are classified as macrosomic. Meanwhile there are no detailed data on the incidence of macrosomia babies in Indonesia.
What causes a large baby's weight at birth?
Large babies may have different genetic codes or certain medical conditions in the womb that can accelerate fetal growth. But health experts reveal that the trend of large babies is more closely related to the number of mothers who are obese before and during pregnancy.
If you have diabetes before pregnancy (pre-gestational diabetes) or you have diabetes during pregnancy (gestational diabetes), you are also more likely to conceive and give birth to a large baby.
On the other hand, most of the causes of cases of large birth weight remain unexplained, and most macrosomic infants do not have recognizable risk factors.
What are the risks of having a big baby?
Macrosomia is related to infant mortality at birth, neonatal injury, maternal death, and complications of cesarean delivery. Later, these babies also face an increased risk of health problems that hinder their quality of life, such as obesity, diabetes and metabolic syndrome.
Meanwhile, mothers who give birth to large babies through normal labor are at risk of developing birth-related injuries, including major tears in the uterus, vagina and rectum, and injuries to the sit / tail bone. Normal birth of a baby macrosomia also increases your risk of experiencing severe bleeding during childbirth which can be fatal due to uterine muscles that do not contract after giving birth (uterine atony). A large baby also means you are more likely to have a caesarean section, which has its own risks.
1. Injury to a baby during labor
It takes more time and a more complicated process to be able to successfully give birth to a large baby through normal labor. Macrosomia babies are at risk of developing shoulder dystocia during the birth process. Shoulder dystocia is a condition in which the shoulder is trapped inside the mother's body after the doctor manages to pull her head out. This is a rare situation, but it is very serious because it can cause severe injury and even death.
Baby's shoulders trapped under the bones of the mother's pelvis during labor can cause nerve damage to the baby's shoulders, arms and neck. Nerve damage occurs in 2-16% of infants who have shoulder dystocia. In rare cases, your baby can end up with a broken collarbone or upper arm bone.
Infant mortality can occur due to asphyxia (lack of oxygen) or birth trauma that can cause physical or neurological defects, such as brachial palsy and clavicle fractures. Giving birth to a large baby can also result in the baby needing breathing assistance after labor and having thicker heart muscle abnormalities. Large babies are also at high risk for jaundice.
2. Obese babies
Women who are overweight or obese before pregnancy have a two to three times higher risk of developing gestational diabetes during pregnancy compared to women who are not obese before.
Excess blood sugar and insulin production can cause excess growth and fat storage, making the baby's weight bigger. In the womb, these babies are accustomed to high sugar levels, but when they are born, their food source is suddenly cut off. In the end, large babies tend to have low blood sugar and need to be monitored from birth.
3. Metabolic syndrome
Metabolic syndrome is a group of conditions characterized by increased blood pressure, high blood sugar levels, excess body fat around the waist, or abnormal cholesterol levels. Metabolic syndrome can increase the risk of heart disease, stroke and diabetes. Large babies are at high risk of developing metabolic syndrome because they have underlying health conditions, such as obesity and insulin resistance.
4. Autism
The risk of autism does not only appear to occur in infants with low birth weight (LBW), but also in babies born with excess weight. The results of a 2013 study from Manchester University found that large babies born with a weight above 4.5 kg showed an increased risk of autism by as much as 60 percent, compared to babies with normal weight.
Researchers suspect that the link between large-born babies and the risk of autism starts with the baby's growth problems during the womb, which may be caused by abnormalities in placental function. Anything that promotes developmental and growth disorders will also affect the baby's brain development. This risk appears very high in babies where they grow poorly and continue in the womb until after 40 weeks. This may be because these babies are exposed to unhealthy conditions in the mother's womb for a long time.