Exceptionally large newborn

**Definition:** An exceptionally large baby is defined as having a weight at birth of > 4500 g, regardless of gestational age at birth.

**Long definition:** An exceptionally large baby, also known as fetal macrosomia, is defined as a weight at birth of > 4000 g. regardless of fetal gestational age. Risks factors for fetal macrosomia include: a history of previous macrosomia, increased pre pregancy weight, increased weight gain during pregnancy, multiparity, male fetus, maternal age <17 years and a positive 50-g glucose screen with a negative 3 hour glucose tolerance test. Shoulder dystocia is the most serious complication associated with fetal macrosomia. In addition, there is an increased incidence of fracture of the clavicle and brachial plexus injury

**Exclusions:** - Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent - Syndrome of infant of mother with gestational diabetes