DOI: 10.2337/diaspect.20.2.82 © 2007 by the American Diabetes Association
What is so bad about a big baby? Although the concept of a large, fat neonate conjures up joy, wealth, and a bouncing baby of health, when large-for-gestational-age (LGA) infants are the result of intrauterine overnutrition, the infants become pathologically overweight. Then, the consequences are not so happy. When obese neonates have metabolic aberrances, and if the majority of the fat concentration is in their viscera, these infants are destined to develop the metabolic syndrome and most likely will eventually develop diabetes.
Because the most immediate concern surrounding the birth of a large infant
is trauma, such as shoulder dystocia, brachial palsy, and hypoxia with
subsequent cerebral palsy, obstetricians have concentrated their treatment,
management strategies, and concerns on determining the optimal timing and mode
of delivery to ensure that such babies are alive and born without injury.
However, once these babies are given to their pediatrician and the
obstetricians are relieved of responsibility for them, the obstetricians
redirect decisions about
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