Children Born Small for Gestational Age: Differential Diagnosis, Molecular Genetic Evaluation, and Implications

Area of Science:

• Pediatrics
• Endocrinology
• Genetics

Background:

• Small for gestational age (SGA) describes infants with birth weight/length below -2 SD score (SDS).
• Causes of SGA are diverse, including maternal, placental, and fetal factors.
• While most SGA infants achieve catch-up growth, approximately 10% remain short.

Purpose of the Study:

• To review the implications of being born small for gestational age.
• To discuss the efficacy and safety of growth hormone (GH) treatment for short children born SGA.
• To explore potential add-on therapies for optimizing adult height.

Main Methods:

• Literature review of studies on SGA, growth, and treatment outcomes.
• Analysis of short-term and long-term consequences of SGA.
• Evaluation of GH therapy and combined GnRH agonist treatment in SGA populations.

Main Results:

• Short children born SGA benefit from GH treatment, increasing adult height by an average of 1.25 SDS.
• Combined gonadotropin-releasing hormone agonist therapy may be considered for severe cases with predicted adult height below -2.5 SDS.
• GH treatment for SGA does not appear to confer additional health risks.

Conclusions:

• SGA is a heterogeneous condition with potential long-term health implications.
• GH therapy is an effective and safe treatment for improving adult height in short children born SGA.
• Further consideration of combined therapies may be warranted for specific patient subgroups.