Posted by My OB said WHAT?!?.
Jan
29
Posted by My OB said WHAT?!?.
“Your Baby Should Probably Been Labeled As Macrosomic…”
“Your baby should probably have been labeled as macrosomic actually.” - Family Practice doctor to mother at 2 week newborn checkup. This was said because the mother is 4’11”. The baby weighed 8 lb 10 oz.
There are 19 comments to this post.
It says something about how long I’ve been reading this site that my first response was “WOW! A doctor took the mother’s size into consideration while evaluating the size of her child!”
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The Deranged Housewife Reply:
January 29th, 2012 at 11:30 am (Quote)
I know. At my daughter’s last appointment (she’s 5) the PA was “worried” about her being so thin and only in the 15th percentile or whatever, and I just said, “Oh come on, you should see my husband. He’s 6’1″ and a beanpole!” LOL
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It amazes me how many doctors misuse the terms macrosomic and microsomic. Many use them interchangeably with Large for Gestational Age and Small for Gestational Age. They are not the same thing. I have two SGA babies and two microsomic (IUGR) babies, and there was a big difference in the way they looked and acted.
But it doesn’t sound like this baby met the criteria for either label, or if he did, that the doctor didn’t take the time to actually check for it, just made the assumption.
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yippee skippee… not sure why you have to label it anything at all, as long as you give mom a fair chance at labor and delivery instead of scaring her into surgery because the Dr’s are unsure of their skills or something. because we really don’t care about your paycheck Dr.
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Morgaine had this to say,
Jan 29, 2012 @ 11:31 pm (Quote)
Jen – Ok, so I did a quick google search, and what I found is the terms macrosomia and large for gestational age being used synonymously. So what is the difference?
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Jen Reply:
January 30th, 2012 at 6:10 pm (Quote)
If you take all the babies born at a certain gestational age and plot their birth weight on a chart, you’d find a nice bell curve. Babies in the bottom 10% are small for gestational age, and the top 10% are large for gestational age. In other words, they’re big/small compared to other babies of the same gestation. It doesn’t necessarily indicate a problem. After all, someone has to be the biggest and smallest, and genetics plays a big role in that.
The terms microsomia and macrosomia, on the other hand, are *supposed* to refer to the ratio of head circumference to chest circumference. If a baby has inadequate nutrition in utero (growth restriction), the brain gets priority while the body stalls. Microsomic babies have relatively large heads on small bodies.
On the other end, macrosomic babies have access to more nutrition than they need (common with, for example, untreated gestational diabetes). Since the brain is getting everything it needs, the body gets the extra. These babies have relatively small heads on large bodies. Most (but not all) macrosomic babies are LGA, but not all LGA babies are macrosomic, and the same on the small end.
Somewhere along the line, it got decided that all LGA babies are labled macrosomic whether they really have head/body disproportion or not, solely on the basis of being large. Also, any baby over 4000gm is “macrosomic” just because, even if that weight is normal for gestational age. (You’d expect more “overdue” babies to be above that weight just because they’re older, so they may not even be the biggest 10%.)
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Macrosomic babies are born with “excessive” weight, usually 4,000 gms (8#13) or above.
LGA babies are babies who have two of the following characteristics above the 90th percentile lines for their gestational age: weight, length, head circumference.
Usually, a macrosomic baby will also be LGA and vice versa.
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Jade Reply:
January 30th, 2012 at 7:55 am (Quote)
Fetal macrosomia has been defined in several different ways, including birth weight of 4000-4500 g (8 lb 13 oz to 9 lb 15 oz) or greater than 90% for gestational age after correcting for neonatal sex and ethnicity. Based on these definitions, macrosomia affects 1-10% of all pregnancies
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This is mine! It was kind of funny to me, because I’ve been with this fp for 12 years now, so she should have known better than to come up with something like that. She knows I research everything. All I said was, actually, macrosomic is considered for 8 lb 13 oz and up. But, yeah, it surprised me she would even say something like that based on “my” size and not the baby’s actual size. I was shaking my head.
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Kit had this to say,
Jan 31, 2012 @ 6:24 am (Quote)
My son was 9lbs 7oz at birth. I was told he was LGA (not macrosomic). But when our FP plotted his weight on the graph, he was 85th percentile, which is not the top 10%. So now I’m really confused. Maybe the difference is that my FP took into account that he was 7 days overdue and the hospital did not?
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Add Your Comment.
And you should probably be labeled as a putz.
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The Deranged Housewife Reply:
January 29th, 2012 at 11:27 am The Deranged Housewife(Quote)
LOL!
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