WIC 337 History of Birth of a Large for Gestational Age Infant

History of birth of a large for gestational age infant is defined as follows:

Presence of condition diagnosed, documented, or reported by a physician or someone working under a physician’s orders, or as self reported by applicant/participant/caregiver. See Clarification for more information about self‐reporting a diagnosis.

Women with a previous delivery of an infant weighing greater than 9 lbs. (4000 grams) are at an increased risk of giving birth to a large for gestational age infant (1). Macrosomia may be an indicator of maternal diabetes (current or gestational) or a predictor of future diabetes (2).

The incidence of maternal, fetal, and neonatal complications is high with neonates weighing greater than 9 lbs. (4000 grams). Risks for the infant include dystocia, meconium aspiration, clavicular fracture, brachia plexus injury, and asphyxia (3).

1. Boyd ME, Usher RH, McLean FH. Fetal macrosomia: prediction, risks, proposed management. Obstet. Gynecol. 1983; 61:715‐22.

2. Institute of Medicine. WIC nutrition risk criteria a scientific assessment. Washington (DC): National Academy Press; 1996. p. 117.

3. Institute of Medicine. Nutrition during pregnancy. Washington, (DC): National Academy Press; 1990. p. 190.

Self‐reporting of “History of …” conditions should be treated in the same manner as self‐reporting of  current conditions requiring a physician’s diagnosis, i.e., the applicant may report to the CPA that s/he was diagnosed by a physician with a given condition at some point in the past.  As with current conditions, self‐diagnosis of a past condition should never be confused with self‐reporting.