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Neonatal Problems and Infancy Growth of Term SGA Infants: Does "SGA" Definition Need to Be Re-evaluated?

Saygin Abali1, Serdar Beken2, Eda Albayrak2

  • 1Department of Pediatrics, Pediatric Endocrinology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.

Frontiers in Pediatrics
|December 6, 2021
PubMed

Insights

Infants with birth weight below -2 SDS experienced higher rates of severe hypoglycemia and polycythemia. This study highlights potential risks associated with stricter small-for-gestational-age definitions, prompting further research into infant growth and health outcomes.

Area of Science:

  • Neonatalogy
  • Pediatric Endocrinology
  • Growth and Development

Background:

  • The definition of small-for-gestational-age (SGA) infants remains debated among clinicians.
  • Understanding the implications of different SGA definitions on early health and growth is crucial for clinical practice.

Purpose of the Study:

  • To compare early neonatal problems and infancy growth between term infants with birth weight (BW) < -2 SDS and those with BW between the 10th percentile (-1.28 SDS) and -2 SDS.
  • To evaluate the clinical significance of different SGA definitions in identifying infants at risk for postnatal complications and growth issues.

Main Methods:

  • A retrospective cohort study involving term infants, excluding preterm infants, multiple gestations, and those with congenital anomalies.
  • Infants were categorized into three groups: Group 1 (BW < -2.00 SDS), Group 2 (BW between -1.28 and -2.00 SDS), and Group 3 (optimal-for-gestational-age as control).
  • Data collected included incidence of severe hypoglycemia, polycythemia, and anthropometric measurements (length, weight) at 1 and 2 years of age.

Main Results:

  • Group 1 exhibited the highest incidence of severe hypoglycemia (10.8%), significantly higher than Groups 2 (0.8%) and 3 (0.7%).
  • Polycythemia incidence was 5.4% in Group 1 and 2.3% in Group 2, both higher than the control group (0.0%).
  • Short stature ratios at 1 and 2 years were similar across all groups; overweight/obesity ratios at 1 year showed no significant differences.

Conclusions:

  • Infants with birth weight SDS below -2 experience higher rates of short-term disturbances like hypoglycemia and polycythemia.
  • The findings suggest that a stricter definition of SGA (BW SDS < -2) may identify infants at higher risk for immediate postnatal complications.
  • Further long-term studies are warranted to fully elucidate the growth and health implications of different SGA definitions.

Keywords:
hypoglycemiaobesityoverweightshort staturesmall for gestational age

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