Small for gestational age: concept, diagnosis and neonatal characterization, follow-up and recommendations.

Fecha de publicación: 09/08/2024

Autores de IIS La Fe

• María Cernada Badía

  Autor

Participantes ajenos a IIS La Fe

• Diez Lopez, Ignacio
• Galan, Laura
• Boix, Hector
• Ibanez, Lourdes
• Couce, Maria L
• en representacion del Grupo Espanol para el estudio del nino PEG de la
• SEEP y del Comite de Estandares Sociedad Espanola de Neonatologia

Grupos

• Perinatología

  

  Leader

  Máximo Vento Torres

Abstract

Newborns who do not reach a weight appropriate for their gestational age and sex can be classified in different ways. This article defines the concepts of small for gestational age (SGA) and intrauterine growth restriction, as well as the underlying causes of these conditions, with the goal of establishing consensus definitions for these patients, in whom treatment with growth hormone throughout childhood may be indicated and who may be at risk of developing endocrine or metabolic disorders in puberty and adulthood. Most SGA children experience spontaneous catch-up growth that is usually completed by age 2 years. In SGA children who remain short, treatment with recombinant human growth hormone is effective, increasing adult height. Small for gestational age infants with rapid catch-up growth and marked weight gain are at increased risk of premature adrenarche, early puberty, polycystic ovary syndrome (girls), insulin resistance and obesity, all of which are risk factors for type 2 diabetes and metabolic syndrome in adulthood. The SGA status can affect different areas of neurodevelopment and manifest at different stages in life; neurodevelopmental outcomes are better in SGA infants with spontaneous catch-up growth. Due to the potential risks associated with SGA, adequate characterization of these patients at birth is imperative, as it allows initiation of appropriate follow-up and early detection of abnormalities.