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[Comment] Should pregnancies be induced for impending macrosomia?

Fetal macrosomia (usually defined as an estimated fetal weight or birthweight >4000 g or ≥4500 g) is associated with various perinatal complications. Irrespective of which weight threshold is used, macrosomic fetuses have higher rates of shoulder dystocia and subsequent birth trauma than do non-macrosomic fetuses.1 Additionally, women with macrosomic fetuses are at high risk of caesarean deliveries and other complications, such as postpartum haemorrhage and venous thromboembolism.2 One of the strongest risk factors for fetal macrosomia is prepregnancy obesity, but because preconception consultations are rarely done for most obese women, the best way to prevent fetal macrosomia is with close counselling and follow-up of women throughout pregnancy to provide advice on avoiding weight gain in excess of guidelines for gestational weight gain from the US Institute of Medicine.