The following causes can make an infant large for gestational age, EXCEPT:
Correct Answer: Maternal smoking
Description: When the infant's weight is above the ninetieth percentile, the infant is considered large for gestational age. It can be a consequence of genetic predisposition with similar large infants in previous pregnancies of the mother. Glucose crosses the placenta but insulin cannot. Consequently, fetal hyperglycemia and hyperinsulinemia develop and results in increased somatic growth of the fetus. Beckwith-Wiedemann syndrome is multifactorial disorder which includes macrosomia, omphalocele, macroglossia, and hypoglycemia. Hydrops fetalis, is characterized by severe chronic anemia and hypoproteinemia, and it can also become apparent as an infant large for gestational age. On the other hand, maternal smoking results in asymmetric growth retardation due to adverse effect on fetal nutrition. Exposed infants are small for gestational age. Ref: Burns D.M. (2012). Chapter 395. Nicotine Addiction. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
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