Introduction/Aim. Those born small for gestational age are all newborns whose weight, length and head circumference deviate by more than minus two standard deviations in relation to the same parameters of average children of the same sex, corresponding gestational age and population. The goal is their early recognition and adequate treatment. They should be clearly distinguished from premature babies, children born before the 37th week of gestation, and it should be noted that all children born small for gestational age are always born after intrauterine growth arrest. Poor and economically underdeveloped countries show a higher prevalence of children small for gestational age. At birth, these children have a higher risk of asphyxia, infections, neurological disorders, and in the later period of life, low growth, cognitive dysfunctions, disorders of pubertal development and metabolic syndrome. If they have not achieved growth compensation by the age of four and their height is less than minus 2.5 standard deviations, treatment with recombinant growth hormone is suggested. The recommended starting dose of growth hormone is 35 mg/kg of body weight per day. Adequate adjustment of the dose is achieved by monitoring the growth rate at 6 - 12 and IGF-1 at 3 - 6 months after starting therapy, and then once a year. The treatment is stopped in the period of adolescence, when the growth rate is < 2 cm per year. Conclusion. Early recognition of children born small for gestational age provides the opportunity to avoid numerous complications later in life with adequate and timely treatment.
References
1.
Mericq V, Ong KK, Bazaes R, Peña V, Avila A, Salazar T, et al. Longitudinal changes in insulin sensitivity and secretion from birth to age three years in small- and appropriate-for-gestational-age children. Diabetologia. 2005;48(12):2609–14.
2.
Hilaire M, Andrianou XD, Lenglet A, Ariti C, Charles K, Buitenhuis S, et al. Growth and neurodevelopment in low birth weight versus normal birth weight infants from birth to 24 months, born in an obstetric emergency hospital in Haiti, a prospective cohort study. BMC Pediatrics. 2021;21(1).
3.
Cortese M, Moster D, Wilcox AJ. Term Birth Weight and Neurodevelopmental Outcomes. Epidemiology. 2021;32(4):583–90.
4.
Hollo O, Rautava P, Korhonen T, Helenius H, Kero P, Sillanpää M. Academic Achievement of Small-for-Gestational-Age Children at Age 10 Years. Archives of Pediatrics & Adolescent Medicine. 2002;156(2):179.
5.
O’Keeffe MJ, O’Callaghan M, Williams GM, Najman JM, Bor W. Learning, Cognitive, and Attentional Problems in Adolescents Born Small for Gestational Age. Pediatrics. 2003;112(2):301–7.
6.
Yi KH, Yi YY, Hwang IT. Behavioral and intelligence outcome in 8- to 16-year-old born small for gestational age. Korean Journal of Pediatrics. 2016;59(10):414.
7.
Jiang YZ, Zhu M, F X. Dehydroepiandrosterone sulfate and insulin of prepubertal girls born small for gestational age. Zhonghua Er Ke Za Zhi. 2006;44(1):37–40.
8.
Ong KK, Potau N, Petry CJ, Jones R, Ness AR, Honour JW, et al. Opposing Influences of Prenatal and Postnatal Weight Gain on Adrenarche in Normal Boys and Girls. The Journal of Clinical Endocrinology & Metabolism. 2004;89(6):2647–51.
9.
Garcia-Beltran C, Carreras-Badosa G, Bassols J, Malpique R, Plou C, de Zegher F, et al. microRNAs in newborns with low birth weight: relation to birth size and body composition. Pediatric Research. 2022;92(3):829–37.
10.
Chaudhari S, Otiv M, A C. Pune low birth weight study-cognitive abilities and educational performance at twelve years. Indian Pediatr. 2004;41(2):121–8.
11.
Arends NJT, Boonstra VH, Duivenvoorden HJ, Hofman PL, Cutfield WS, Hokken‐Koelega ACS. Reduced insulin sensitivity and the presence of cardiovascular risk factors in short prepubertal children born small for gestational age (SGA). Clinical Endocrinology. 2005;62(1):44–50.
12.
Zanelli SA, Rogol AD. Short children born small for gestational age outcomes in the era of growth hormone therapy. Growth Hormone & IGF Research. 2018;38:8–13.
13.
Lee HS, Kum CD, Rho JG, Hwang JS. Long-term effectiveness of growth hormone therapy in children born small for gestational age: An analysis of LG growth study data. PLOS ONE. 17(4):e0266329.
14.
de Zegher F, Hokken-Koelega A. Growth Hormone Therapy for Children Born Small for Gestational Age: Height Gain Is Less Dose Dependent Over the Long Term Than Over the Short Term. Pediatrics. 2005;115(4):e458–62.
15.
Deodati A, Cianfarani S. The Rationale for Growth Hormone Therapy in Children with Short Stature. Journal of Clinical Research in Pediatric Endocrinology. :23–32.
16.
van der Steen M, Smeets CCJ, Kerkhof GF, Hokken-Koelega ACS. Metabolic health of young adults who were born small for gestational age and treated with growth hormone, after cessation of growth hormone treatment: a 5-year longitudinal study. The Lancet Diabetes & Endocrinology. 2017;5(2):106–16.
17.
Netchine I, van der Steen M, López-Bermejo A, Koledova E, Maghnie M. New Horizons in Short Children Born Small for Gestational Age. Frontiers in Pediatrics. 9.
18.
Collett-Solberg PF, Ambler G, Backeljauw PF, Bidlingmaier M, Biller BMK, Boguszewski MCS, et al. Diagnosis, Genetics, and Therapy of Short Stature in Children: A Growth Hormone Research Society International Perspective. Hormone Research in Paediatrics. 2019;92(1):1–14.
19.
He H, Miao H, Liang Z, Zhang Y, Jiang W, Deng Z, et al. Prevalence of small for gestational age infants in 21 cities in China, 2014–2019. Scientific Reports. 11(1).
20.
Organization WH. WHO Expert Committee on Physical Status: the Use and Interpretation of Anthropometry (1993. World Health Organization. 1995;
21.
Clayton PE, Cianfarani S, Czernichow P, Johannsson G, Rapaport R, Rogol A. Management of the Child Born Small for Gestational Age through to Adulthood: A Consensus Statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society. The Journal of Clinical Endocrinology & Metabolism. 2007;92(3):804–10.
22.
Lee PA, Chernausek SD, Hokken-Koelega ACS, Czernichow P. International Small for Gestational Age Advisory Board Consensus Development Conference Statement: Management of Short Children Born Small for Gestational Age, April 24–October 1, 2001. Pediatrics. 2003;111(6):1253–61.
23.
Vayssière C, Sentilhes L, Ego A, Bernard C, Cambourieu D, Flamant C, et al. Fetal growth restriction and intra-uterine growth restriction: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015;193:10–8.
24.
Boguszewski MC, Mericq V, Bergada I, Damiani D, Belgorosky A, Gunczler P, et al. Latin American Consensus: Children Born Small for Gestational Age. BMC Pediatrics. 2011;11(1).
Fenton TR. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatrics. 3(1).
27.
Lee AC, Katz J, Blencowe H, Cousens S, Kozuki N, Vogel JP, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. The Lancet Global Health. 2013;1(1):e26–36.
28.
Zeve D, Regelmann MO, Holzman IR, Rapaport R. Small at Birth, but How Small? The Definition of SGA Revisited. Hormone Research in Paediatrics. 2016;86(5):357–60.
29.
Räisänen S, Gissler M, Sankilampi U, Saari J, Kramer MR, Heinonen S. Contribution of socioeconomic status to the risk of small for gestational age infants – a population-based study of 1,390,165 singleton live births in Finland. International Journal for Equity in Health. 2013;12(1):28.
30.
Tamaro G, Pizzul M, Gaeta G, Servello R, Trevisan M, Böhm P, et al. Prevalence of children born small for gestational age with short stature who qualify for growth hormone treatment. Italian Journal of Pediatrics. 2021;47(1).
31.
Ludvigsson JF, Lu D, Hammarström L, Cnattingius S, Fang F. Small for gestational age and risk of childhood mortality: A Swedish population study. PLOS Medicine. 15(12):e1002717.
32.
Collins JW, Mariani A, Rankin K. African-American women’s Upward Economic Mobility and Small for Gestational Age Births: A Population-Based Study. Maternal and Child Health Journal. 2018;22(8):1183–9.
33.
Li P, Lu Y, Qie D, Feng L, He G, Yang S, et al. Early-life weight gain patterns of term small-for-gestational-age infants and the predictive ability for later childhood overweight/obesity: A prospective cohort study. Frontiers in Endocrinology. 13.
34.
Hwang IT. Long-term care, from neonatal period to adulthood, of children born small for gestational age. Clinical Pediatric Endocrinology. 2019;28(4):97–103.
35.
Renes JS, van Doorn J, Hokken-Koelega ACS. Current Insights into the Role of the Growth Hormone-Insulin-Like Growth Factor System in Short Children Born Small for Gestational Age. Hormone Research in Paediatrics. 2019;92(1):15–27.
36.
Pepe G, Calafiore M, Valenzise M, Corica D, Morabito L, Pajno GB, et al. Bone Maturation as a Predictive Factor of Catch-Up Growth During the First Year of Life in Born Small for Gestational Age Infants: A Prospective Study. Frontiers in Endocrinology. 11.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
