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Aetiology and classification of small for gestational age infants
M J O'Callaghan1, J M Harvey, D I Tudehope
1Growth and Development Clinic, Mater Children's Hospital, Brisbane, Queensland, Australia.
Insights
Maternal factors like size, weight gain, smoking, and psychosocial stress are key causes of small for gestational age (SGA) infants. Anthropometric indexes like the ponderal index are not reliable for identifying growth patterns.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Pediatric Growth and Development
Background:
- Intrauterine growth retardation (IUGR) affects a significant number of newborns.
- Identifying etiological factors and patterns of growth retardation is crucial for infant health.
- Existing methods for assessing growth patterns in small for gestational age (SGA) infants require further evaluation.
Purpose of the Study:
- To identify significant etiological factors contributing to SGA infants.
- To assess the effectiveness of anthropometric indexes in distinguishing patterns of growth retardation.
- To explore the relationship between maternal characteristics and SGA development.
Main Methods:
- A case-control study involving 84 SGA infants and 81 controls.
- Comparison of maternal biological, lifestyle, and psychosocial factors between groups.
- Analysis of anthropometric indexes, including the ponderal index, in relation to growth patterns.
Main Results:
- Maternal factors such as smaller maternal size, inadequate weight gain, prior SGA births, and smoking were strongly linked to SGA status.
- Increased rates of poor parental education and unemployment were observed in the SGA group.
- Mothers of SGA infants exhibited higher prevalence of hypertension, depression, and stress symptoms.
- The ponderal index was ineffective in differentiating between disproportionate and proportionate growth retardation patterns.
Conclusions:
- Biological, lifestyle, and psychosocial factors are critical contributors to intrauterine growth retardation.
- The utility of the ponderal index for identifying specific growth retardation patterns remains uncertain and requires further investigation.
Objective:
To determine important aetiological factors in small gestational age (SGA) infants and the effectiveness of anthropometric indexes in identifying patterns of growth retardation.
Methodology:
Eighty-four SGA infants and 81 controls were enrolled. Maternal biological, lifestyle and psychosocial factors were compared for the total group and the term Caucasian subset. Anthropometric indexes were also examined in relation to growth patterns.
Results:
Decreased maternal size, poor weight gain, previous SGA infant and smoking were significantly associated with SGA status. Poor parental education and unemployment was increased in the study group. Mothers of SGA infants, especially the term Caucasian group, had a greater prevalence of hypertension and depressive and stress symptomatology. Ponderal index failed to identify discreet patterns of disproportionate/proportionate growth retardation.
Conclusion:
Biological, lifestyle and psychosocial differences remain important aetiological factors of intrauterine growth retardation. Identification of specific patterns of growth retardation by ponderal index remains controversial.