Children Born Small for Gestational Age: Differential Diagnosis, Molecular Genetic Evaluation, and Implications
Children born small for gestational age (SGA), defined as a birth weight and/or length below -2 SD score (SDS), comprise a heterogeneous group. The causes of SGA are multifactorial and include maternal lifestyle and obstetric factors, placental dysfunction, and numerous fetal (epi)genetic abnormalities. Short-term consequences of SGA include increased risks of hypothermia, polycythemia, and hypoglycemia. Although most SGA infants show catch-up growth by 2 years of age, ∼10% remain short. Short children born SGA are amenable to GH treatment, which increases their adult height by on average 1.25 SD. Add-on treatment with a gonadotropin-releasing hormone agonist may be considered in early pubertal children with an expected adult height below -2.5 SDS. A small birth size increases the risk of later neurodevelopmental problems and cardiometabolic diseases. GH treatment does not pose an additional risk.
|Persistent URL||dx.doi.org/10.1210/er.2018-00083, hdl.handle.net/1765/112140|
Finken, M.J, van der Steen, M, Smeets, C.C.J, Walenkamp, M.J.E, de Bruin, C, Hokken-Koelega, A.C.S, & Wit, J.M. (2018). Children Born Small for Gestational Age: Differential Diagnosis, Molecular Genetic Evaluation, and Implications. Endocrine Reviews, 39(6), 851–894. doi:10.1210/er.2018-00083