Management of the Child Born Small for Gestational Age through to Adulthood: A Consensus Statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society

Abstract

The diagnosis of SGA should be based on accurate anthropometry at birth including weight, length, and head circumference. We recommend early surveillance in a growth clinic for those without catch-up. Early neurodevelopment evaluation and interventions are warranted in at-risk children. Endocrine and metabolic disturbances in the SGA child are recognized but infrequent. For the 10% who lack catch-up, GH treatment can increase linear growth. Early intervention with GH for those with severe growth retardation (height sd score, <-2.5; age, 2-4 yr) should be considered at a dose of 35-70 microg/kg x d. Long-term surveillance of treated patients is essential. The associations at a population level between low birth weight, including SGA, and coronary heart disease and stroke in later life are recognized, but there is inadequate evidence to recommend routine health surveillance of all adults born SGA outside of normal clinical practice.

Systematic review indicates postnatal growth in term infants born small‐for‐gestational‐age being associated with later neurocognitive and metabolic outcomes

“…However, faster postnatal growth and weight gain can lead to taller adult heights, but this study did not review that factor 54. Although the evidence for a similar positive impact on neurocognitive outcomes is relatively sparse, the potential for such long‐term benefits on height and neurocognition makes the promotion of infancy weight gain an appealing policy.…”

Copy number variants in patients with short stature

“…In two previous papers from our group, 11,12 we have described the results of a candidate gene approach in children with short stature, either associated with a low birth size (small for gestational age, SGA) 13 or with a normal birth size (idiopathic short stature). 14 In this article, we describe the results of a genome-wide analysis for CNVs using SNP arrays in short children, in an effort to identify novel gene variants associated with short stature.…”

Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis

“…4 Infants with gastroschisis frequently have risk factors for impaired growth and delayed neurodevelopment, including premature birth, small for gestational age (SGA) or nutritional compromise early in life. 5 Approximately 67% of infants with gastroschisis are born prematurely, 6 20% are SGA, 7 and 15 to 20% experience prolonged intestinal dysfunction requiring parenteral nutrition for longer than 4 weeks. 6 The impact of gastroschisis on growth and neurodevelopment, based on previous studies, is uncertain because of limitations in study design, including small cohort sizes, the inclusion of patients with unrelated abdominal wall defects, evaluations by report only and the inclusion of patients born greater than 20 years ago.…”