Small for dates babies: are they really a problem?

One hundred and sixty four infants less than 5th centile for gestation specific birth weight were born at gestations greater than or equal to 37 weeks in the Cambridge Maternity Hospital in 1982. Of these, 60 were less than 2-3rd centile--that is, greater than 2 standard deviations below mean birth weight. Serious disease was rare: only six (4%) had recognisable malformations. There was only one neonatal death, a baby less than 2-3rd centile with the Neu-Laxova syndrome. Nine (5%) became hypoglycaemic but with no serious symptoms: one of these was already on the neonatal unit with respiratory distress syndrome and was given intravenous dextrose, and the remaining eight all responded to milk feeds. Only 13 out of the 164 patients (8%) were admitted to the neonatal unit, eight of the 12 survivors for 48 hours or less. Small for dates babies of 37 weeks' gestation or more pose few neonatal problems and can be safely cared for on a postnatal ward.