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Variation in size at birth in infants born small for gestational age in Lithuania
R Verkauskiene1, K Albertsson Wikland, A Niklasson
1Department of Paediatric Endocrinology, Kaunas University of Medicine, Lithuania.
Insights
Infants born small for gestational age (SGA) show varied body proportions, with some exhibiting a brain-sparing effect. Placental weight to birthweight ratio strongly indicates impaired prenatal linear growth in these infants.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Human Growth and Development
Background:
- Infants born small for gestational age (SGA) exhibit significant heterogeneity in body proportions.
- Understanding this heterogeneity is crucial for identifying distinct growth patterns and potential health outcomes.
- Placental size is a key factor influencing fetal growth and neonatal anthropometry.
Purpose of the Study:
- To describe the heterogeneity in body proportions of infants born small for gestational age (SGA).
- To investigate the relationship between placental size and neonatal anthropometric measurements in SGA infants.
- To compare anthropometric data between SGA subtypes and appropriate-for-gestational age (AGA) infants.
Main Methods:
- Evaluated anthropometry in 107 symmetrically and asymmetrically growth-retarded SGA infants (birthweight <-2 SD).
- Compared SGA infants with 181 appropriate-for-gestational age (AGA) infants (birthweight and length +/- 2 SD).
- Assessed placental weight to birthweight (PW/BW) ratio and its correlation with infant measurements.
Main Results:
- Two-thirds of SGA infants were light (SGA(W)), one-third was light and short (SGA(WL)).
- SGA(WL) infants displayed larger head-to-length ratios, suggesting a brain-sparing effect.
- SGA(WL) infants had the lowest mean placental weight but the highest PW/BW ratio, inversely correlated with linear growth.
Conclusions:
- Heterogeneity exists in SGA infants, suggesting two groups represent a continuum of intrauterine growth retardation.
- SGA(WL) infants may experience initial trophic growth reduction followed by linear growth retardation.
- The PW/BW ratio is a significant indicator of impaired prenatal linear growth.
Unlabelled:
The aim of this study was to describe the heterogeneity in body proportions of infants born small for gestational age (SGA), defined by birthweight, and to study the relationship of placental size with neonatal anthropometric measurements. Anthropometry was evaluated in 107 symmetrically and asymmetrically growth-retarded infants born SGA (birthweight <-2 SD) and compared with 181 appropriate-for-gestational age infants (AGA; birthweight and length +/- 2 SD). Study children were born at Kaunas University Hospital during the period from 1 January 1998 to 25 August 2000. Two-thirds of SGA children were light (SGA(W)) and one-third was both light and short (SGA(WL)) for gestational age. Infants in both SGA groups were significantly leaner than AGA children. SGA(WL) infants had significantly larger heads in relation to their length compared with SGA(W) and even AGA children, probably indicating a brain-sparing effect. SGA(WL) children had the lowest mean placental weight, but the highest placental weight to birthweight (PW/BW) ratio. The PW/BW ratio was inversely correlated with most infant measurements; the strongest negative relationship was observed with birthlength and lower leg length.
Conclusion:
There is heterogeneity in children born SGA, defined by birthweight. It is suggested that the two SGA groups represent the continuum of intrauterine growth retardation, with an initial reduction in trophic growth and a subsequent retardation of linear growth. The PW/BW ratio is a strong indicator for impaired prenatal linear growth.