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Concept
Small for gestational age
Summary
Small for gestational age (SGA) newborns are those who are smaller in size than normal for the gestational age. SGA is most commonly defined as a weight below the 10th percentile for the gestational age. SGA predicts susceptibility to hypoglycemia, hypothermia, and polycythemia. By definition, at least 10% of all newborns will be labeled SGA. All SGA babies should be watched for signs of failure to thrive, hypoglycemia and other health conditions.
Being small for gestational age is broadly either:
Being constitutionally small, or caused by a genetic trait of the baby
Intrauterine growth restriction, also called "pathological SGA"
The condition is defined by birth weight and/or length.
Intrauterine growth restriction is generally diagnosed by measuring the mother's uterus, with the fundal height being less than it should be for that stage of the pregnancy. If it is suspected, the mother will usually be sent for an ultrasound to confirm.
Ninety percent of babies born SGA catch up in growth by the time they reach 2 years old. For the 10 percent of those that are SGA without catchup growth by 2 years old, an endocrinologist should be consulted. Some cases warrant growth hormone therapy.
Hypoglycemia is common in asymmetrical SGA babies because their larger brains burn calories at a faster rate than their usually limited fat stores hold . Hypoglycemia is treated by frequent feedings and/or additions of cornstarch-based products (such as Duocal powder) to the feedings.
There are some common conditions and disorders found in many that are SGA (and especially those that are SGA without catchup growth by 2 years old).
Gastroenterologist - for gastrointestinal issues such as reflux and/or delayed gastric emptying
Dietitian - to address caloric deficits. Dietitians are usually brought in for cases that include failure to thrive. According to the theory of thrifty phenotype, causes of growth restriction also trigger epigenetic responses in the fetus that are otherwise activated in times of chronic food shortage, and if the offspring develops in an environment rich in food, it may be more prone to metabolic disorders such as obesity and type II diabetes.
Official source
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