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Severity of growth retardation and physical condition at birth in small for gestational age infants
1Department of Pediatrics, Free University School of Medicine, Amsterdam, The Netherlands.
Insights
The ponderal index categorizes small for gestational age (SGA) infants. Disproportionally small infants, often with congenital anomalies, had higher mortality, regardless of intrauterine growth retardation (IUGR) severity.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Fetal Medicine
Background:
- Small for gestational age (SGA) infants are classified using the ponderal index.
- This index differentiates between proportional and disproportional growth retardation.
- Disproportional growth is often attributed to adverse intrauterine conditions.
Purpose of the Study:
- To evaluate the ponderal index's effectiveness in identifying fetal disorders.
- To assess the relationship between the ponderal index and the severity of intrauterine growth retardation (IUGR).
Main Methods:
- A cohort of 142 SGA infants was studied.
- Infants were categorized based on ponderal index (proportional vs. disproportional growth).
- Infants were also grouped by IUGR severity.
Main Results:
- Twelve newborns (8.5%) had congenital anomalies, predominantly disproportionally small.
- Fourteen infants expired, all of whom were disproportionally small.
- Infant proportionality was independent of IUGR severity; most SGA infants were disproportionally small.
Conclusions:
- The ponderal index is valuable in identifying SGA infants with potential underlying fetal disorders.
- Disproportionally small SGA infants, particularly those with anomalies, face higher mortality risks.
- Proportionally small SGA infants may exhibit better adaptation to intrauterine conditions, correlating with survival.
Abstract:
Ponderal index divides small for gestational age (SGA) infants into two categories, based upon proportional and disproportional growth retardation. The latter group supposedly suffered from unfavorable intrauterine conditions. The aim of the study was investigation of the value of the ponderal index in the discrimination of underlying fetal disorders and its dependency upon the severity of the intrauterine growth retardation (IUGR). In a cohort of 142 SGA infants we found 12 newborns with congenital anomalies; most of the newborns were disproportionally small. Fourteen newborns expired in the Neonatal Intensive-Care Unit for various reasons, in general not directly related with the IUGR. All of them were disproportionally small. The newborns were divided into two groups according to the severity of IUGR. Proportionality was independent of this severity, indicating that most SGA fetuses remain disproportionally small during long-standing IUGR. It is likely, however, that the proportionally small ones adjust better to the poor intrauterine conditions, since they all survived.