Small for gestational age |
Small for gestational age (SGA) newborns are those who are smaller in size than normal for the gestational age. SGA is most commonly defined as a weight below the 10th percentile for the gestational age.[1] SGA predicts susceptibility to hypoglycemia, hypothermia, and polycythemia.[2] By definition, at least 10% of all newborns will be labeled SGA. All SGA babies should be watched for signs of failure to thrive, hypoglycemia and other health conditions.
Being small for gestational age is broadly either:
The condition is defined by birth weight and/or length.
Intrauterine growth restriction is generally diagnosed by measuring the mother's uterus, with the fundal height being less than it should be for that stage of the pregnancy. If it is suspected, the mother will usually be sent for an ultrasound to confirm.
Ninety percent of babies born SGA catch up in growth by the time they reach two years old. For the ten percent of those without catchup growth by two years old, an endocrinologist should be consulted. Some cases warrant growth hormone therapy.
Hypoglycemia is common in asymmetrical SGA babies because their larger brains burn calories at a faster rate than their usually limited fat stores hold. Hypoglycemia is treated by frequent feedings and/or additions of cornstarch-based products (such as Duocal powder) to the feedings.
Some common conditions and disorders found in many that are SGA (and especially those without catchup growth by two years old).
For intrauterine growth restriction (during pregnancy), possible treatments include the early induction of labor, though this is only done if the condition has been diagnosed and seen as a risk to the health of the fetus.
If small for gestational age babies have been the subject of intrauterine growth restriction, formerly known as intrauterine growth retardation,[4] the term "SGA associated with intrauterine growth restriction" is used.Intrauterine growth restriction refers to a condition in which a fetus is unable to achieve its genetically determined potential size. This functional definition seeks to identify a population of fetuses at risk for modifiable but otherwise poor outcomes. This definition intentionally excludes fetuses that are small for gestational age (SGA) but are not pathologically small.[5] Infants born SGA with severe short stature (or severe SGA) are defined as having a length less than 2.5 standard deviation scores below the mean.[6]
A related term is low birth weight, defined as an infant with a birth weight (that is, mass at the time of birth[7]) of less than 2500 g (5 lb 8 oz), regardless of gestational age at the time of birth.Other related terms include "very low birth weight", which is less than 1500 g, and "extremely low birth weight", which is less than 1000 g.[8] Normal weight at term delivery is 2500 g–4200 g.
SGA is not a synonym of low birth weight, very low birth weight, or extremely low birth weight.For example, with a 35-week gestational age delivery, 2250 g weight is appropriate for gestational age but is still low birth weight. One third of low-birth-weight neonates – infants weighing less than 2500 g – are small for gestational age.
There is an 8.1% incidence of low birth weight in developed countries, and 6–30% in developing countries. Much of this can be attributed to the health of the mother during pregnancy. One third of babies born with a low birth weight are also small for gestational age. Infants that are born at low birth weights are at risk of developing neonatal infection.
Both low and high maternal serum Vitamin D (25-OH) are associated with higher incidence SGA in white women, although the correlation does not seem to hold for African American women.[9]
22 | 467 | 92 | 354 | |
23 | 553 | 109 | 416 | |
24 | 626 | 129 | 473 | |
25 | 714 | 156 | 529 | |
26 | 819 | 186 | 597 | |
27 | 935 | 215 | 677 | |
28 | 1073 | 242 | 770 | |
29 | 1211 | 269 | 882 | |
30 | 1396 | 309 | 1018 | |
31 | 1588 | 336 | 1166 | |
32 | 1800 | 371 | 1335 | |
33 | 2033 | 405 | 1538 | |
34 | 2296 | 428 | 1772 | |
35 | 2560 | 440 | 2021 | |
36 | 2799 | 441 | 2261 | |
37 | 3028 | 456 | 2477 | |
38 | 3209 | 432 | 2665 | |
39 | 3333 | 419 | 2810 | |
40 | 3417 | 416 | 2904 | |
41 | 3486 | 422 | 2958 | |
42 | 3512 | 429 | 2985 | |
43 | 3550 | 444 | 2981 | |
44 | 3505 | 503 | 2952 |