ACTA FAC MED NAISS 2023;40(2):141-148 |
Review article
UDC:
Running title: Small for Gestational Age
Children Born Small for Gestational Age
Jelena Miolski1,2, Maja Ješić1,3, Vlada Bojić3, Smiljka Kovačević1,3, Jelena Blagojević3, Vera Zdravković1,3
1University of Belgrade, Faculty of
Medicine, Belgrade, Serbia
SUMMARY
Introduction/Aim. Those born small for gestational age are all newborns
whose weight, length and head circumference deviate by more than minus
two standard deviations in relation to the same parameters of average
children of the same sex, corresponding gestational age and population.
The goal is their early recognition and adequate treatment. They should
be clearly distinguished from premature babies, children born before the
37th week of gestation, and it should be noted that all
children born small for gestational age are always born after
intrauterine growth arrest. Poor and economically underdeveloped
countries show a higher prevalence of children small for gestational
age. At birth, these children have a higher risk of asphyxia,
infections, neurological disorders, and in the later period of life, low
growth, cognitive dysfunctions, disorders of pubertal development and
metabolic syndrome. If they have not achieved growth compensation by the
age of four and their height is less than minus 2.5 standard deviations,
treatment with recombinant growth hormone is suggested. The recommended
starting dose of growth hormone is 35 μg/kg of body weight per day.
Adequate adjustment of the dose is achieved by monitoring the growth
rate at 6 - 12 and IGF-1 at 3 - 6 months after starting therapy, and
then once a year. The treatment is stopped in the period of adolescence,
when the growth rate is < 2 cm per year.
Conclusion. Early recognition of children born small for gestational age
provides the opportunity to avoid numerous complications later in life
with adequate and timely treatment.
Jelena Miolski
e-mail: jelena.miolski@doctor.com