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Catch-Up Growth in Full-Term Small for Gestational Age Infants: A Systematic Review

Susan C Campisi1,2, Sarah E Carbone3,4, Stanley Zlotkin1,5,6,7,2

  • 1Department of Nutritional Sciences, University of Toronto, Toronto, Canada.

Advances in Nutrition (Bethesda, Md.)
|January 17, 2019
PubMed

Insights

Catch-up growth (CUG) in full-term small for gestational age (SGA) infants is common, with a median prevalence of 87.4%. However, varied definitions hinder global program planning for these infants.

Area of Science:

  • Neonatal Health
  • Pediatric Growth Studies
  • Global Child Health

Background:

  • Small for gestational age (SGA) infants, comprising 16% globally, face heightened risks for adverse developmental and adult health outcomes.
  • Catch-up growth (CUG) is a critical factor influencing the long-term health trajectory of SGA infants, particularly in low- and middle-income countries.
  • Understanding the prevalence of CUG in full-term SGA (FT-SGA) infants is essential for targeted health interventions.

Purpose of the Study:

  • To systematically review and determine the global prevalence of catch-up growth (CUG) in full-term small for gestational age (FT-SGA) infants.
  • To identify the heterogeneity in definitions and reference standards used for classifying SGA and CUG globally.
  • To highlight the need for standardized definitions to facilitate effective program implementation for FT-SGA infants.

Main Methods:

  • A comprehensive literature search was conducted across major scientific databases (MEDLINE, Pubmed, Embase, Web of Science, Scopus) and grey literature.
  • 3137 studies were initially identified, with the final analysis including 11 studies meeting the inclusion criteria.
  • Due to significant heterogeneity in methodologies, a meta-analysis was not feasible.

Main Results:

  • The median prevalence of CUG among FT-SGA infants was found to be 87.4% across various definitions of SGA and CUG.
  • Significant heterogeneity was observed in the classification of SGA (9 unique reference populations) and CUG (6 approximations).
  • This variability in definitions prevented a meta-analysis and complicates the assessment of global need for CUG interventions.

Conclusions:

  • While CUG is highly prevalent in FT-SGA infants, the lack of standardized definitions for SGA and CUG poses a significant challenge for global health planning.
  • Standardized definitions and reference standards are urgently needed to accurately assess the global need for and to rationally plan programs addressing CUG in FT-SGA infants.
  • Establishing clear, consistent criteria is crucial for implementing effective interventions for this vulnerable infant population.

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