Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable degrees with an onset, or first recognized, during pregnancy. Fetuses of obese women with gestational diabetes mellitus have a higher risk of developing macrosomia than those of nonobese women with gestational diabetes mellitus.Maternal diabetes during pregnancy can lead to a transgenerational transmission of diabetes risk.Fetal macrosomia, resulting from fetal hyperinsulinemia in response to maternal diabetes, might be a predictor of later glucose intolerance.Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. Summary: Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called ‘large for gestational age'. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. Background: Fetal macrosomia, defined as a birth weight ≥4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM).
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