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Small for dates babies: are they really a problem?

R A Jones, N R Roberton

    Archives of Disease in Childhood
    |September 1, 1986
    PubMed
    Summary
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    Infants born at or after 37 weeks gestation who are small for dates rarely experience serious neonatal issues. These babies can be safely managed on a postnatal ward, minimizing neonatal unit admissions.

    Area of Science:

    • Neonatal Medicine
    • Pediatrics
    • Obstetrics

    Background:

    • Infants born small for gestational age (SGA) at term may present unique neonatal challenges.
    • Defining the risks associated with SGA infants born at or after 37 weeks gestation is crucial for appropriate care management.

    Purpose of the Study:

    • To evaluate the incidence of serious neonatal complications in infants born small for gestational age (SGA) at term (≥37 weeks gestation).
    • To determine the necessity and duration of neonatal unit admissions for these infants.

    Main Methods:

    • Retrospective analysis of 164 infants born at Cambridge Maternity Hospital in 1982.
    • Infants were identified as small for gestational age if below the 5th centile for gestation-specific birth weight.
    • Data collected included birth weight centiles, presence of malformations, neonatal complications (hypoglycemia, respiratory distress), and neonatal unit admission rates.

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    Main Results:

    • Only 4% of SGA infants (n=6) had recognizable malformations.
    • One neonatal death occurred in an infant with Neu-Laxova syndrome (less than 2-3rd centile).
    • Hypoglycemia affected 5% (n=9) but was asymptomatic and responsive to milk feeds; only 8% (n=13) required neonatal unit admission, with most for short durations.

    Conclusions:

    • Term infants (≥37 weeks gestation) who are small for gestational age (SGA) generally pose minimal neonatal risks.
    • The majority of these infants can be safely managed on a postnatal ward, reducing the burden on neonatal intensive care resources.