Late hyperglycemia in pregnancy is associated with

Fetal macrosomia Definition: Those infants exceeding the 90th percentile for a given gestational week are usually used as the threshold for macrosomia or large-for-gestational age (LGA) bihweight The primary effect attributed to gestational diabetes is excessive fetal size or macrosomia Maternal hyperglycemia prompts fetal hyperinsulinemia, paicularly during the second half of gestation . This in turn stimulates excessive somatic growth or macrosomia. Except for the brain, most fetal organs are affected by the macrosomia that characterizes the fetus of a diabetic woman. Infants are anthropometrically different from other large-forgestational age (LGA) infants with excessive fat deposition on the shoulders and trunk, which predisposes to shoulder dystocia or cesarean delivery The incidence of macrosomia rises significantly when mean maternal blood glucose concentrations chronically exceed 130 mg/dL Reference: William&;s Obstetrics; 24th edition; Chapter 57