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Small for gestational age: short stature and beyond

Paul Saenger1, Paul Czernichow, Ieuan Hughes

  • 1Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York 10467, USA. PHSaenger@aol.com

Endocrine Reviews
|February 27, 2007
PubMed

Insights

Children born small for gestational age (SGA) face long-term metabolic risks. Early catch-up growth may mitigate these risks, while growth hormone treatment appears safe for those not catching up.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Health

Background:

  • Up to 10% of neonates are born small for gestational age (SGA).
  • SGA infants are at increased risk for later-life metabolic diseases, including insulin resistance, obesity, cardiovascular disease, and type 2 diabetes mellitus.
  • Metabolic consequences are often observed in adults who experienced spontaneous catch-up growth in childhood.

Purpose of the Study:

  • To explore the long-term metabolic health of individuals born SGA.
  • To investigate the impact of catch-up growth and growth hormone (GH) treatment on metabolic outcomes in SGA individuals.
  • To evaluate current infant feeding practices in light of SGA-related metabolic risks.

Main Methods:

  • Review of existing literature on SGA, catch-up growth, and metabolic disease.
  • Analysis of data on the effects of early catch-up growth strategies.
  • Examination of recent findings on long-term GH treatment in SGA individuals.

Main Results:

  • Early appropriate catch-up growth may mitigate some metabolic consequences of intrauterine growth restriction.
  • Excessive weight gain should be avoided in SGA infants.
  • Long-term GH treatment in SGA individuals who do not catch up does not appear to increase the risk of type 2 diabetes mellitus or metabolic syndrome in young adulthood.

Conclusions:

  • Optimizing early growth in SGA infants is crucial for long-term metabolic health.
  • Growth hormone therapy is a potentially safe option for SGA individuals with short stature who do not achieve catch-up growth.
  • Further research into infant feeding practices for SGA infants is warranted.

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