What maternal condition increases the risk of a macrosomic infant?

Gestational diabetes is the maternal condition that significantly increases the risk of having a macrosomic infant. This condition occurs when a woman develops insulin resistance during pregnancy, leading to elevated blood sugar levels. When a pregnant woman has high blood sugar, it can cause excessive growth in the fetus, resulting in macrosomia, which is defined as an infant weighing more than 4,000 grams (approximately 8 pounds, 13 ounces) at birth.

The excess glucose in the mother's bloodstream is transported to the fetus, where it stimulates the production of insulin. Insulin acts as a growth hormone in the fetus, promoting increased fat deposition and ultimately leading to larger birth weight. Without intervention, gestational diabetes can lead to complications for both mother and child, including delivery difficulties and increased risk of childhood obesity.

Other conditions listed, such as hypertension, pre-eclampsia, and anemia, can affect pregnancy outcomes but do not have the same direct correlation with fetal growth as gestational diabetes does. Hypertension and pre-eclampsia primarily affect the mother's health and placental function, potentially leading to growth restriction rather than increased size. Anemia, while it can lead to complications, typically does not have a direct association with the risk of delivering a macrosomic