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Subclassification of small for gestational age children with persistent short stature: growth patterns and response

Wietske Ester1, Ellen Bannink, Marije van Dijk

  • 1Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. w.ester@erasmusmc.nl

Hormone Research
|December 7, 2007
PubMed

Insights

Subclassifying short small for gestational age (SGA) children by birth measurements reveals distinct patterns in development and growth. These subgroups show varied gestation, delivery, and postnatal growth, but similar growth hormone treatment responses.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Neonatology

Background:

  • Small for gestational age (SGA) is a common condition with varied etiologies and growth outcomes.
  • Understanding subgroups within SGA can refine clinical management and research.
  • Birth anthropometrics offer a potential method for subclassification.

Purpose of the Study:

  • To determine if subclassification of short SGA children based on birth anthropometrics (length, weight, head circumference) can differentiate patterns in gestation, delivery, postnatal growth, and response to growth hormone (GH) treatment.
  • To analyze parental height and target height differences among these subgroups.

Main Methods:

  • 201 short SGA children were classified into three groups: SGA(L), SGA(L+W), and SGA(L+W+HC) based on birth length, weight, and head circumference SDS (≤ -2.00).
  • Data collected included gestational age, delivery method, anthropometrics at birth and up to 3 years, GH treatment response, and parental height.

Main Results:

  • SGA(L+W+HC) children had the shortest gestational age and highest C-section rate. SGA(L+W) children showed the highest rate of gestational hypertension.
  • SGA(L+W+HC) children were born shorter but exhibited greater height and head circumference growth in the first three years, though head circumference remained smaller at age 3.
  • No significant differences were observed in growth response to GH treatment across the subgroups. SGA(L) children had shorter parental and target heights.

Conclusions:

  • Subclassification of short SGA children using birth anthropometrics is a valuable method for identifying distinct patterns in gestation, delivery, and postnatal growth.
  • While subgroups differ in early development, their response to growth hormone treatment is comparable.
  • This subclassification aids in a more nuanced understanding and investigation of SGA children.
Abstract

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