Macrosomia, if it occurs, typically becomes evident at 26 to 28 weeks gestation. Complications associated with macrosomia include fetopelvic disproportion leading to operative delivery, shoulder dystocia, and neonatal hypoglycemia.20 There is an increased incidence of hyperbilirubinemia, hypocalcemia, respiratory distress syndrome, and polycythemia in the neonate. Long-term complications can include obesity, diabetes during childhood, impaired motor function, and higher rates of inattention and hyperactivity.1,11