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Aetiology, morphology and body composition of infants born small for gestational age
A Lapillonne1, N Peretti, P S Ho
1Department of Neonatology, Hôpital Edouard Herriot, Lyon, France.
Insights
Infants born small for gestational age (SGA) exhibit diverse growth patterns. Proper perinatal care and nutrition are crucial for improving outcomes in these infants.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Fetal Medicine
Background:
- Infants born small for gestational age (SGA) represent a diverse population with varying birth characteristics.
- The timing and duration of intrauterine insults significantly influence infant physical condition and body composition.
- Intrauterine growth retardation (IUGR) can be symmetrical or asymmetrical, impacting postnatal growth trajectories.
Purpose of the Study:
- To differentiate the characteristics and growth patterns of infants with symmetrical versus asymmetrical IUGR.
- To highlight the importance of perinatal management and nutritional support for SGA infants.
- To explain the heterogeneity observed in infants born small for gestational age.
Main Methods:
- Comparative analysis of body composition in SGA infants with different IUGR patterns.
- Review of growth trajectories and catch-up growth potential in SGA neonates.
- Correlation of perinatal management strategies with infant outcomes.
Main Results:
- Symmetrical IUGR infants share body composition with appropriate-for-gestational-age infants but tend to have persistent growth deficits.
- Asymmetrical IUGR infants show reduced fat deposition but have a higher likelihood of catch-up growth.
- Appropriate perinatal management, including early nutrition, is associated with reduced mortality and morbidity in SGA infants.
Conclusions:
- Infants born SGA are not a homogenous group; their growth patterns depend on the nature of intrauterine insults.
- Early nutritional interventions and appropriate perinatal care are key to optimizing outcomes for infants with asymmetrical IUGR.
- Understanding the specific type of IUGR is essential for predicting postnatal growth and guiding clinical management.
Abstract:
Infants born small for gestational age (SGA) are a heterogeneous group. Both the timing and duration of the intrauterine insult determine the physical condition and body composition of the infant at birth. Infants with symmetrical intrauterine growth retardation (IUGR) have a similar body composition at birth to weight-matched infants born appropriate for gestational age. However, these infants are more likely to remain shorter and lighter than normal infants. In contrast, infants with asymmetrical IUGR have reduced fat deposition but are more likely to exhibit catch-up growth during the first few months of life. The low mortality and morbidity rates in infants born SGA observed in recent studies are linked to their appropriate perinatal management, including adequate early nutritional support.