Challenge of large babies

Clinicians working in maternity services face an increasing challenge from the number of "large" babies being born, experts warned today.

A new review warns there is "no consensus" on how to handle delivery but calls for a holistic approach and regular assessment.

Many countries have seen a 15 to 20 per cent increase in the number of large babies, linked to the increasing size of mothers and the spread of diabetes, according to the report in The Obstetrician & Gynaecologist.

Obstetrician San San Aye sets the size of a "large" baby as 4.5kg – or 9.9 lbs – and warns that ultrasound scans frequently give inaccurate estimates of the size of a baby before birth.

Mr Aye, of North Devon District Hospital, Barnstaple, UK, said: "Excessive birth weight increases the risk of shoulder dystocia and caesarean birth substantially and this review highlights how best to manage the situation.

"It is important for clinicians to be aware of the risks associated with foetal macrosomia and be aware of the long-term implications."

He added: "Managing the situation holistically is important making sure all the mothers circumstances are taken into account."

Journal editor Jason Waugh said: "This review gives us an informed approach to managing the macrosomic fetus and with the growing rate of larger babies it is vital regular and thorough assessments are carried out on these babies throughout pregnancy and labour."

Aye SS, MillerV, Saxena S, Farhan M. Management of large-for-gestational-age pregnancy in non-diabetic women. The Obstetrician & Gynaecologist 2010;12:250?256.