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Updated: Aug 15, 2025

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Etiological subgroups of term small-for-gestational-age and childhood health outcomes
Fang Fang1,2, Yan Chen3, Qian Chen2
1Developmental and Behavioral Pediatric Department & Child Primary Care Department, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, 200092, China.
Insights
Small-for-gestational-age (SGA) infants have varied causes and health outcomes. Fetal factors increase low IQ risk, while physiological factors raise growth restriction risk in SGA children.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Biology
Background:
- Small-for-gestational-age (SGA) is a condition with diverse origins.
- Understanding etiology-specific outcomes is crucial for targeted interventions.
Purpose of the Study:
- To investigate childhood health outcomes in term SGA infants based on distinct etiological subgroups.
- To identify specific risks associated with different causes of SGA.
Main Methods:
- Utilized data from the Collaborative Perinatal Project.
- Categorized SGA etiological factors into maternal, fetal, placental, environmental, and physiological groups.
- Analyzed primary child outcomes: low IQ and growth restriction in 8417 term infants.
Main Results:
- SGA due to fetal factors showed the highest risk for low IQ (aOR=1.94).
- SGA due to physiological factors presented the highest risk for growth restriction (aOR=6.04).
- Increased risk for low IQ and growth restriction correlated with the number of SGA risk factors.
Conclusions:
- Etiology-specific term SGA impacts child health outcomes differently.
- Findings support individualized management of SGA infants in the era of precision medicine.
Background:
Small-for-gestational-age (SGA) has a heterogeneous etiology. Our study aimed to examine the childhood health outcomes of etiology-distinct term SGA subgroups.
Methods:
Data from the Collaborative Perinatal Project were used. The etiological factors of SGA were categorized into five groups: maternal, fetal, placental, environmental and physiological factors. Primary child outcomes included low IQ and growth restriction. A total of 8417 term infants were eligible.
Results:
Compared with AGA, SGA children due to fetal factors had the highest risk of low IQ (aOR = 1.94, 95% CI: 1.45-2.59). SGA infants due to physiological factors had the highest risk of growth restriction (aOR = 6.04, 95% CI: 3.93-9.27). SGA children had a higher risk of growth restriction with the aOR ranging from 3.05 (95% CI: 2.36-3.96) to 5.77 (95% CI: 4.29-7.75) for the number of risk factors that the SGA infants had from 1 to 5. SGA children with any risk factor were associated with a higher risk of lower IQ with the aOR ranging from 1.59 (95% CI: 1.31-1.94) to 1.96 (95% CI: 1.50-2.55). SGA without the five types of etiologies was not associated with adverse child outcomes except for growth restriction (aOR = 3.82, 95% CI: 2.62-5.55).
Conclusion:
Term SGA of different etiologies may lead to different child health outcomes.
Impact:
Our study found that SGA of different etiologies may lead to different child health outcomes. Compared with AGA, SGA children due to fetal factors had the highest risk of low IQ. SGA infants due to physiological factors had the highest risk of growth restriction. SGA babies should not be treated the same. In the era of precision medicine, our findings may help pediatricians and parents better manage SGA babies according to different etiologies and the number of risk factors.
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