Giant infant

Japanese: 巨大児 - きょだいじ（英語表記）Giant infant

What is the disease?

External deformity ( Foreign Affairs Agency ) It refers to a newborn with no macroscopic abnormalities such as ovarian hypertension and a birth weight of 4000g or more. It is generally believed that newborns born to diabetic mothers tend to be macrosomic, but in reality, the proportion of newborns born to diabetic mothers among macrosomic babies is less than 20%, and there are other risk factors involved.

What is the cause?

Basically, fetal development depends on genetic factors and the intrauterine environment, which in turn depends on the function of the placenta. For example, excessive glucose passage through the placenta leads to excessive fetal development.

There are two types of macrosomia. One is called symmetric macrosomia, which is a genetic result and develops in a normal intrauterine environment. The fetus is large and has no other abnormalities. The problem is Shoulder dystocia ( Healthy ) (The upper body gets caught, making it difficult to pass through the birth canal.)

The other type is called asymmetric macrosomia. It is seen in newborns born to diabetic mothers and is often caused by poor mother blood sugar control. This type is characterized by enlargement of organs, including the heart, liver, lungs, adrenal glands, and kidneys. spleen ( Hizo ) Swelling such as the following is observed. Due to hyperglycemia in the mother, a large amount of glucose is transferred to the fetus through the placenta, and as a result, the fetus secretes a large amount of a hormone called insulin to regulate blood sugar, which is related to weight gain and causes the fetus to become macrosomic.

How symptoms manifest

In newborns of diabetic mothers, respiratory problems, hypoglycemia, hypocalcemia, polycythemia, hyperbilirubinemia (neonatal jaundice ( Royal ) ), and various symptoms including heart failure.

Testing and diagnosis

It is important to check for any maternal complications, understand the progress of the pregnancy, and check for the presence of the above-mentioned symptoms.

Treatment methods

Severe hypoglycemia may occur, requiring glucose infusion. Respiratory problems may require oxygen administration and artificial respiration. Therefore, it is very important for pregnant women with diabetes to keep their blood sugar levels well controlled.

Hajime Yamazaki

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　外表奇形(がいひょうきけい)などの肉眼的異常がなく、出生体重が4000g以上である新生児をいいます。一般に糖尿病の母体から出生した新生児は巨大児になる傾向があるとされていますが、実際には巨大児のなかで糖尿病母体児が占める割合は2割以下であり、その他の危険因子が存在します。

原因は何か

　基本的には胎児の発育は遺伝因子と子宮内環境に依存しています。子宮内環境は胎盤の機能に依存しています。たとえば、胎盤を介してのブドウ糖の通過が過剰になると胎児の発育が過剰になります。

　巨大児は2つのタイプに分類されます。ひとつは対称性巨大児といわれるもので、遺伝的な結果生じ、正常な子宮内環境下で発育します。胎児は大きい以外に異常を認めません。問題点は分娩時の肩甲難産(けんこうなんざん)（上半身が引っかかり、産道を通過しづらくなること）です。

　もうひとつのタイプは非対称性巨大児といわれるものです。糖尿病の母体から出生した新生児にみられるもので、母体の血糖コントロールが不良な場合に多いとされています。このタイプは臓器の腫大を特徴とし、心臓、肝臓、肺、副腎、脾臓(ひぞう)などの腫大が認められます。母体が高血糖のため胎盤を通して多量のブドウ糖が胎児に移行し、その結果、胎児では血糖の調節のためにインスリンというホルモンが多量に分泌され、これが体重増加に関係して巨大児になるとされています。