3P-RT-1
NATURAL HISTORY OF GROWTH IN SMALL FOR GESTATIONAL AGE
(SGA) CHILDREN IN THE EARLY LIFE
Gzernichow P
Robert Debre Hospital, Paris, France
Babies with a
birth weigh or birth length below a particular percentile are describe as small
for gestational age (SGA).The definition of SGA infants depends on the accurate
determination of gestational age (GA) and on the precision in the evaluation of
weight measurement at birth. Indeed different criteria have been used for
auxological definition of SGA. In most publications the definition of being SGA
relies on birth weight alone using different cut-off levels such as 10,5,3
centile for GA or below 2 SD below the mean for GA. Birth length has been used
less frequently for the diagnosis of SGA. Ponderal index as also been used to
describe the relation between weight and length: in ¡°symetric¡± SGA both weight
and length are reduced and in ¡°asymetric¡± cases weight is reduced more than
length.
It is now accepted
that growth retardation is a consequence of decreased fetal production of IGF1
and insulin. When adequate nutrition is given after delivery, endocrine
parameters are quickly normalized and plasma concentration of both hormone are
normal by 3 month of life.
Several studies
are available on the consequences being SGA on postnatal growth and final
height. Due to improvement in the methods used to take care of early postnatal
nutrition results varies in the survey conducted in the last 30 year. In brief
the outcome has been greatly improved.
Catch up growth occurs
in most in not all children born SGA but the duration and importance of the
catch up vary from on child to another. In the most recent studies in Europe
this catch up is insufficient and close to 10% of cases will remain-2SD below
the mean for height at the age of 2 years. Prematurity and severity of growth
retardation are strong predictors of short stature at this age. After 2 years
of age catch up is infrequent and small stature will persist throughout
childhood and adolescence, and will influence strongly final height.