Talk:Large for gestational age

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[edit] greater than 90% of the normal weight for that gestational age

"greater than 90% of the normal weight for that gestational age, adjusted for sex and ethnicity."

This doesn't make sense. 100% of the normal weight, ie the normal weight, is >90% and can not be abnormally large. Should it say >190%, or something else?

I agree with the above poster. Unless I'm missing something, I think the line should be changed to "greater than 90% over the normal weight for that gestational age" or "greater than 190% of the normal weight for that gestational age".
I've attempted to reword that to clarify it a bit more. The "90th percentile" birth weight refers to the top 10% weights of average newborns which works out (not taking into consideration sex or ethnicity) to around 4250g. I hope its clearer now. violet/riga (t) 21:47, 31 May 2005 (UTC)

[edit] "Occurs in up to 10% of pregnancies"

The lead notes that macrosomai "occurs in up to 10% of pregnancies". If macrosomia is based on a birth weight that is in the 90th percentile or above, wouldn't this mean macrosomia occurs in 10% of pregnancies, not "up to"? --Westendgirl 05:36, 1 Jun 2005 (UTC)

It's the 90th percentile adjusted for gestational age, sex and ethnicity. So a newborn may be classed as being above the 90th percentile of all births but it may not figure in the 90th percentile after the adjustment. I agree that it's quite a daft classification and that's why people tend to use the fixed weight nowadays. violet/riga (t) 09:27, 1 Jun 2005 (UTC)
Perhaps this should be noted in a footnote, and the 10% moved out of the lead definition. We probably don't want a one-line description that needs footnoting. --Westendgirl 22:36, 2 Jun 2005 (UTC)

[edit] kind of offensive

The chart is labeled "appropriate for gestational age". It should use some term other than "appropriate", and "adequate" is no good either. These work:

  • normal
  • average
  • usual
  • common

(BTW, when you fix the chart, please also put pounds and ounces on the right side)

The problem with "appropriate" is that such weights are not appropriate for all babies. The appropriate weight depends on the size of the parents. The same goes for the "40 weeks" too.

A few examples involving a 6'2" dad and a very healthy 5'10" mom:

  • With my first kid, I knew when conception occurred. (a range of dates) Based on an ultrasound, the hospital chose a gestational age that was off by at least 2 weeks, possibly much more. Based on that, they insisted on inducing birth. At birth the kid showed signs of premature birth. As intelligence runs in the family and is associated with high birth weight, I'm especially upset about this birth.
  • Kid number 3, the healthiest of the bunch, was about 10 pounds (4545 g) at birth. Again, we knew the ultrasound estimate was off by weeks. He was delivered naturally, at home of course, with no problems at all. The mom didn't tear, the baby was very responsive, and so on. Heh, your chart is too small. Almost two years later, this kid is now very tall, bright, and strong. He has conversations, uses the can, and beats up his older brothers.
  • Even my twins went to 40 weeks and were not considered small. (they look tiny after the 10-pounder of course) We got 12.5 pounds of baby out of that birth.

This idea of diagnosing unusual-sized babies as "bad" and then trying to "fix" things makes people get hurt. What if we did that for feet? I'm a U.S. size 14. Maybe a doctor should remove part of my foot to make it "appropriate"? We could even enforce a standard height, skin color, nose shape...

AlbertCahalan 15:05, 4 Jun 2005 (UTC)

Sorry but that is the correct term in use today. The chart shows the median (50th percentile) of AGA along with the upper and lower bounds of what is considered "appropriate" (LGA and SGA). This is all calculated to include all variations in influences on the size (including the size of the parents). I see what you're saying, but that is the classification currently in use.
As for the look of the chart, I'm not entirely happy with it at the moment and have some ideas on how to make it look a bit better, including pounds/ounces on the other Y scale. violet/riga (t) 15:23, 4 Jun 2005 (UTC)
I've reworked the graph now. violet/riga (t) 16:26, 4 Jun 2005 (UTC)
Thanks. I was thinking that you might best just label the graph by percentile, but I like what you did. How do you make graphs like that? AlbertCahalan 17:07, 4 Jun 2005 (UTC)
The original one was made in Excel. This time I used Excel to make the background and plot some of the points, then used Macromedia Fireworks to create the rest of it. I considered adding the percentiles to it but didn't want to further increase its size. violet/riga (t) 17:45, 4 Jun 2005 (UTC)
Think about what "calculated to include all variations in influences on the size (including the size of the parents)" really means. It means you have the average. To have a chart that properly accounts for my family, you'd really need to move the SGA line. My 2812g kid (a "full term" twin) was terribly scrawny. Very long limbs throw off the weight. AlbertCahalan 17:07, 4 Jun 2005 (UTC)
That's true, but it's not really possible to represent every every individual family in a chart. It's also based on released statistics and what is classed as SGA and LGA. It may be silly to categorise the newborns so simply, but it's not saying that an AGA baby isn't scrawny and thin. violet/riga (t) 17:45, 4 Jun 2005 (UTC)
Here's a nice example (happy ending even) of how people can be hurt: a lady, with previous successful experience delivering a 12-pound baby, goes to a hospital to give birth. They insist that her 12-pounder absolutely must be delivered by cesarean. She is stubborn enough to get up and walk out while in labor. She easily gives birth in a different hospital. Meanwhile, the first hospital has gone to a judge to get an emergency custody order that would allow them to force the mother to have a cesarean. (They expect her to come back! WTF???) The mother finds out about the court order when news reporters visit her in the second hospital. (In case you didn't know, cesareans interfere with breastfeeding, create risk of infection and future uterine rupture, and cause a very long and painful recovery.) AlbertCahalan 17:07, 4 Jun 2005 (UTC)
If you could find a source for that it might be good to add it to the article, noting that LGA isn't necessarily a direct lead onto a caesarian. violet/riga (t) 17:45, 4 Jun 2005 (UTC)

[edit] think I found it

Big babies do not always need to be delivered by Caesarean section.

Note that the hospital lied on court papers, over both the mother's reason and over her success with previous children.

AlbertCahalan 01:02, 5 Jun 2005 (UTC)

[edit] Birth weight/merge

Birth weight/merge has been created which merges the following articles:

Comments would be appreciated on this possible way forward. violet/riga (t) 14:12, 5 Jun 2005 (UTC)

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