LARGE FOR GESTATIONAL AGE, MACROSOMIA, OVERGROWTH: AN UPDATE ON DEFINITIONS AND DETERMINANTS

Human growth and development, starting from conception, are characterized by a progressive increase in body and organ dimensions, as well as specific functional maturity, under the influence of genetic as well as environmental and epigenetic determinants. Beyond a possible normal familial trait, increased fetal growth resulting in a large for gestational age newborn, isolated macrosomia or that associated with congenital malformation, can be attributable to both maternal metabolic and genetic pathology. Overgrowth syndromes are a heterogeneous group of diseases characterized by excessive tissue development often concomitant to neurodevelopmental involvement. Recently, an increased risk of fetal overgrowth with Assisted Reproductive Technology has been reported. Thus, in pediatric practice, it is fundamental to monitor any patient who presents with increased growth parameters, variable malformations, neurodevelopmental delay, and distinctive features from birth, aiming to ensure as adequate a medical management as possible, and for some of the disorders, strict tumor monitoring is also necessary.