Inpatient Obstetric Nurse (NCC) Practice Exam

Fetal macrosomia, which is defined as a fetus that is significantly larger than average, often arises from maternal metabolic conditions, particularly gestational diabetes mellitus (GDM). In the case of GDM, elevated maternal blood glucose levels lead to increased insulin production in the fetus. This excess insulin can promote fetal growth and fat deposition, resulting in a larger-than-average baby at birth.

Furthermore, GDM affects the transport of glucose and nutrients to the fetus, causing it to gain weight at a faster rate. The risk of fetal macrosomia increases with the severity and duration of the maternal condition, making close monitoring and management of gestational diabetes crucial for preventing complications related to larger fetal size at delivery.

While other maternal conditions listed can have impacts on pregnancy and fetal health, they do not have the same direct association with the development of macrosomia as is seen with gestational diabetes. For example, placental abruption may lead to complications like preterm labor but does not typically cause increased fetal growth. Preeclampsia and chronic hypertension are also more related to placental insufficiency and may lead to restricted fetal growth rather than macrosomia. Thus, gestational diabetes is the condition most clearly linked to an increased risk of fetal macrosomia.