What Apgar score indicates that the newborn is in good to excellent condition quizlet?

A newborn who weighs more than 90% of newborns of the same gestational age at birth (above the 90th percentile) is considered large for gestational age.

• Newborns may be large because the parents are large or because the mother has diabetes or is obese.

• Doctors take measurements of the mother's abdomen and use ultrasonography to take measurements of the fetus to help estimate the fetus's weight.

• Large babies born to mothers with diabetes are more likely to be overweight as adults.

• Cesarean delivery is sometimes necessary.

• Complications are treated.

Gestational age refers to how far along the fetus is. The gestational age is the number of weeks between the first day of the mother's last menstrual period and the day of delivery. This time frame is often adjusted according to other information doctors receive, including the results of early ultrasound scans, which give additional information regarding the gestational age. A baby is estimated to be due (the due date) at 40 weeks of gestation.

At a gestational age of 40 weeks, boys who weigh more than about 9 pounds 4 ounces (4.2 kilograms) are large for gestational age (LGA). Girls who weigh more than about 9 pounds 1 ounce (4.1 kilograms) are LGA. Doctors use published growth charts or computer apps to evaluate babies at other gestational ages.

Macrosomia (large body) is a related term used to describe infants who weigh more than 9 pounds 15 ounces (4.5 kilograms).

Large newborns may be normal babies who simply are large because the parents are large. However, certain problems in the mother sometimes cause babies to be large for gestational age.

The most common cause of LGA newborns is

Other risk factors for having LGA newborns include

• Having had previous LGA babies

• Genetic abnormalities or syndromes (for example, Beckwith-Wiedemann syndrome or Sotos syndrome)

• Excessive weight gain during pregnancy (the fetus gets more calories as the mother gains more weight)

The reason for excessive growth of the fetus varies but primarily results from an abundance of nutrients combined with hormones in the fetus that stimulate growth. In pregnant women who have poorly controlled diabetes, a large amount of sugar (glucose) crosses the placenta (the organ that provides nourishment to the fetus), resulting in high levels of glucose in the fetus’s blood. The high levels of glucose trigger the release of increased amounts of the hormone insulin from the fetus’s pancreas. The increased amount of insulin results in accelerated growth of the fetus, including almost all organs except the brain, which grows normally.

Symptoms of large-for-gestational-age (LGA) newborns are mainly related to any complications that occur.

Common complications in LGA newborns include the following:

• Low Apgar score Apgar Score

  
  : The Apgar score is a rating of the baby's condition in the first minutes of life. LGA infants tend to have lower Apgar scores and are more likely to require assistance at birth.

• Birth defects Overview of Birth Defects Birth defects, also called congenital anomalies, are physical abnormalities that occur before a baby is born. They are usually obvious within the first year of life. The cause of many birth... read more : Infants of mothers with poorly controlled diabetes have an increased risk of birth defects, including ones that involve the brain Overview of Brain and Spinal Cord Birth Defects Birth defects of the brain and spinal cord can occur in early or late fetal development. Typical symptoms include intellectual disability, paralysis, incontinence, or loss of sensation in some... read more , heart Overview of Heart Defects About one in 100 babies is born with a heart defect. Some are severe, but many are not. Defects may involve abnormal formation of the heart's walls or valves or of the blood vessels that enter... read more , kidneys Kidney Defects There are several different birth defects that affect the kidneys (the two organs that filter waste from the blood to make urine). These defects are not usually apparent at the doctor's examination... read more , digestive tract Overview of Digestive Tract Birth Defects The digestive organs may be incompletely developed or abnormally positioned, causing blockages, or the muscles or nerves of the digestive tract may be defective. Symptoms depend on the location... read more , and lower part of the spine Neural Tube Defects and Spina Bifida Neural tube defects are a certain type of birth defect of the brain, spine, and/or spinal cord. Neural tube defects can result in nerve damage, learning disabilities, paralysis, and death. The... read more .

• Before birth, measurement of the uterus and ultrasonography

• After birth, assessment of gestational age and size and weight of the baby

During pregnancy, doctors measure the distance on the woman's abdomen from the top of the pubic bone to the top of the uterus (fundus). This measurement, called a fundal height measurement, corresponds roughly with the number of weeks of pregnancy. If the measurement is high for the number of weeks, the fetus may be larger than expected.

After birth, LGA is diagnosed by assessing the gestational age and the weight of the baby.

LGA newborns are assessed for any complications. Blood sugar is measured to detect hypoglycemia, and doctors do a thorough examination to look for birth injuries and structural or genetic abnormalities.

The most common problems of LGA infants (hypoglycemia, birth injuries, and lung problems) typically resolve over a few days with no long-term consequences.

As adults, LGA girls have an increased risk of having an LGA infant. All LGA infants are at risk of obesity and may have an increased risk of heart disease.

• Treatment of complications

There is no specific treatment for large-for-gestational-age newborns, but underlying conditions and complications are treated as needed.

Newborns with hypoglycemia are treated with early (within 1 hour after birth) and frequent feedings, or sometimes are given glucose with fluids by vein.

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