Causes of Growth Discrepancy: Large for Gestational Age - Differential Diagnosis Algorithm

Maternal Factors:

 • Multiparity

 • Previous history of large for gestational age fetus

 • Aboriginal, Hispanic, and Caucasian races

 • Maternal co-morbidities (e.g. diabetes, obesity)

 • Excessive weight gain over course of pregnancy (>40 lbs)

Maternal Complications:

 • Prolonged labour

 • Operative vaginal delivery

 • Caesarean section

 • Genital tract lacerations

 • Post-partum hemorrhage

 • Uterine rupture

Fetal Factors:

 • Male infant

 • Prolonged gestation (>41 weeks)

 • Genetic disorder (e.g. Sotos syndrome, Beckwith-Wiedemann syndrome, Weaver's syndrome)

Fetal Complications:

 • Shoulder dystocia

 • Birth injury (brachial plexus injury, clavicular fracture)

 • Cerebral palsy secondary to hypoxia

 • Hypoglycemia

 • Polycythemia

 • Perinatal asphyxia

 • Hyperbilirubinemia



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