• 제목/요약/키워드: Small for gestational age

검색결과 63건 처리시간 0.022초

국내 부당경량아의 현황 (The present condition of Korean children born small for gestational age)

  • 황일태
    • Clinical and Experimental Pediatrics
    • /
    • 제52권2호
    • /
    • pp.137-141
    • /
    • 2009
  • Depending on the definition used, between 3% and 10% of live neonates are small for gestational age (SGA). The definition of SGA requires the following: (1) accurate knowledge of gestational age; (2) accurate measurements at birth of weight, length, and head circumference; (3) a cutoff, which has been variably set at the 10th percentile, 3rd percentile, or at less than 2 standard deviation from the mean, and (4) race and ethnicity-specific growth curve. Consensus statements are needed on the management of growth hormone therapy in SGA children, as well as treatment and long-term health outcomes such as impaired cognitive function, increased risk of adult cardiovascular disease, and type 2 diabetes.

Outcomes of small for gestational age micropremies depending on how young or how small they are

  • Yu, Hee-Joon;Kim, Eun-Sun;Kim, Jin-Kyu;Yoo, Hye-Soo;Ahn, So-Yoon;Chang, Yun-Sil;Park, Won-Soon
    • Clinical and Experimental Pediatrics
    • /
    • 제54권6호
    • /
    • pp.246-252
    • /
    • 2011
  • Purpose: The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA. Methods: The medical records of 415 ELBWIs (birth weight<1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from January 2000 to December 2008, were reviewed retrospectively. Mortality and morbidities were compared by body size groups: very SGA (VSGA), birth weight ${\leq}$3rd percentile; SGA, 3rd to 10th percentile; and appropriate for gestational age (AGA) infants, >10th percentile for gestational age. For gestational subgroup analysis, groups were divided into infants with gestational age ${\leq}24^{+6}$ weeks (subgroup I), $25^{+0}$ to $26^{+6}$ weeks (subgroup II), and ${\geq}27^{+0}$ weeks (subgroup III) Results: Gestational age was $29^{+2}{\pm}2^{+6}$ weeks in the VSGA infants (n=49), $27^{+5}{\pm}2^{+2}$weeks in the SGA infants (n=45), and $25^{+4}{\pm}1^{+4}$ weeks in AGA infants (n=321). Birth weight was $692{\pm}186.6$ g, $768{\pm}132.9$ g, and $780{\pm}142.5$ g in the VSGA, SGA, and AGA groups, respectively. Cesarean section rate and maternal pregnancy-induced hypertension were more common in the VSGA and SGA than in AGA pregnancies. However, chorioamnionitis was more common in the AGA group. The mortalities of the lowest gestational group (subgroup I), and also of the lower gestational group (subgroup I+II) were significantly higher in the VSGA group than the SGA or AGA groups (P=0.020 and P=0.012, respectively). VSGA and SGA infants showed lower incidence in respiratory distress syndrome, ductal ligation, bronchopulmonary dysplasia, intraventricular hemorrhage than AGA group did. However, by multiple logistic regression analysis of each gestational subgroup, the differences were not significant. Conclusion: Of ELBWIs, extremely SGA in the lower gestational subgroups, had an impact on mortality, which may provide information useful for prenatal counseling.

Iron status in small for gestational age and appropriate for gestational age infants at birth

  • Kim, Hyeon A;Park, Sook-Hyun;Lee, Eun Joo
    • Clinical and Experimental Pediatrics
    • /
    • 제62권3호
    • /
    • pp.102-107
    • /
    • 2019
  • Purpose: This study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth. Methods: The clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total iron status. Results: In this study, 115 SGA (GA, $36.5{\pm}2.9weeks$; birth weight [BW], $1,975{\pm}594.5g$) and 717 AGA (GA, $35.1{\pm}3.5weeks$; BW, $2,420.3{\pm}768.7g$) infants were included. The SGA infants had higher hematocrit levels ($50.6%{\pm}5.8%$ vs. $47.7%{\pm}5.7%$, P<0.05) than the AGA infants. No difference in serum ferritin level (ng/mL) was found between the groups (mean [95% confidence interval]: SGA vs. AGA infants, 139.0 [70.0-237.0] vs. 141.0 [82.5-228.5]). After adjusting for gestational age, the SGA infants had lower ferritin levels (147.1 ng/mL [116.3-178.0 ng/mL] vs. 189.4 ng/mL [178.0-200.8 ng/mL], P<0.05). Total body iron stores were also lower in the SGA infants than in the AGA infants (185.6 [153.4-211.7] vs 202.2 [168.7-241.9], P<0.05). Conclusion: The SGA infants had lower ferritin and total body iron stores than the AGA infants. The SGA infants affected by maternal hypertension who were born at late preterm had an additional risk of inadequate iron store. Iron deficiency should be monitored in these infants during follow-up.

Behavioral and intelligence outcome in 8- to 16-year-old born small for gestational age

  • Yi, Kyung Hee;Yi, Yoon Young;Hwang, Il Tae
    • Clinical and Experimental Pediatrics
    • /
    • 제59권10호
    • /
    • pp.414-420
    • /
    • 2016
  • Purpose: We investigated behavioral problems, attention problems, and cognitive function in children and adolescents born small for gestational age (SGA). Methods: Forty-six SGA children born at term and 46 appropriate for gestational age (AGA) children born at term were compared. Psychiatric symptoms were examined with reference to the Korean-Child Behavior Checklist, Korean-Youth Self Report, and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Cognitive function was estimated using the Wechsler Intelligence Scale. Sociodemographic data were recorded from interviews. Results: SGA children had high scores on delinquent behavior, aggressive behavior, and the externalizing scale, and they also showed a propensity for anxiety and depression. The SGA group had a higher mean ADHD-RS score than the AGA group ($10.52{\pm}8.10$ vs.$9.93{\pm}7.23$), but the difference was not significant. The SGA group had a significantly lower verbal intelligence quotient (IQ) than the AGA group, but the mean scores of both groups were within normal limits. Conclusion: This study indicates marked behavioral problems, such as delinquency, aggressiveness, and anxiety and depression, as well as low verbal IQ in the SGA group than in the AGA group. Even in cases in which these symptoms are not severe, early detection and proper treatment can help these children adapt to society.

부당경량아에서의 성장과 성 발달 (Growth and sex differentiation of children born small for gestational age)

  • 김세영
    • Clinical and Experimental Pediatrics
    • /
    • 제52권2호
    • /
    • pp.142-151
    • /
    • 2009
  • The incidence of small for gestational age (SGA) births is frequent, accounting for 2.3% to 8% of all live births. Several childhood and adult diseases are related to early postnatal growth and birth size, and 10% of children born SGA may have a short stature throughout postnatal life. Additionally, they may have abnormal growth hormone (GH)-insulin like growth factor axis, HPA axis, and gonadal function. Permanent changes are detrimental in an environment of nutritional abundance, and predispose SGA children to an array of diseases in adolescence and adulthood. Such changes may also cause premature pubarche, adrenarche, and precocious puberty. The varying results from clinical studies necessitate more prospective case control studies. Reproductive tract abnormalities and reproductive dysfunction are related to SGA births. GH treatment is required for SGA infants who do not experience catch-up growth.

Incidence of congenital hypothyroidism by gestational age: a retrospective observational study

  • Ha Young Jo;Eun Hye Yang;Young Mi Kim;Soo-Han Choi;Kyung Hee Park;Hye Won Yoo;Su Jeong Park;Min Jung Kwak
    • Journal of Yeungnam Medical Science
    • /
    • 제40권1호
    • /
    • pp.30-36
    • /
    • 2023
  • Background: Congenital hypothyroidism (CH) is the leading cause of preventable physical and intellectual disabilities. This study aimed to assess the incidence and clinical characteristics of CH in newborns. Methods: We retrospectively reviewed the medical records of all newborns delivered at the Pusan National University Hospital between January 2011 and March 2021. The incidence of CH was compared according to gestational age, birth weight, and small for gestational age (SGA). The patients aged ≥3 years who could not maintain normal thyroid function and required levothyroxine treatment were diagnosed with permanent CH. Logistic regression analysis was performed to compare CH risks. Results: Of 3,722 newborns, 40 were diagnosed with CH (1.07%). Gestational age and birth weight were significantly associated with CH incidence. The odds ratios (ORs) of CH in infants delivered at 32-37, 28-31, and <28 weeks were 2.568 (95% confidence interval [CI], 1.141-5.778), 5.917 (95% CI, 2.264-15.464), and 7.441 (95% CI, 2.617-21.159) times higher, respectively, than those delivered at term. The ORs of CH in infants weighing 1,500-2,499 g, 1,000-1,499 g, and <1,000 g were 4.664 (95% CI, 1.928-11.279), 11.076 (95% CI, 4.089-29.999), and 12.544 (95% CI, 4.350-36.176) times greater, respectively, than those in infants weighing ≥2,500 g. The OR of CH was 6.795 (95% CI, 3.553-13.692) times greater in SGA than in non-SGA infants. Conclusion: The CH incidence in South Korea has increased significantly compared with that in the past. Gestational age, birth weight, and SGA were significantly associated with CH incidence.

Efficacy and safety of growth hormone treatment for children born small for gestational age

  • Hwang, Il Tae
    • Clinical and Experimental Pediatrics
    • /
    • 제57권9호
    • /
    • pp.379-383
    • /
    • 2014
  • Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve an adult height within the normal target range. GH treatment at a dose of $35-70{\mu}g/kg/day$ should be considered for those with very marked growth retardation, as these patients require rapid catch-up growth. Factors associated with response to GH treatment during the initial 2-3 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. Adverse events due to GH treatment are no more common in the SGA population than in other conditions treated with GH. Early surveillance in growth clinics is strongly recommended for children born SGA who have not caught up. Although high dose of up to 0.067 mg/kg/day are relatively safe for short children with growth failure, clinicians need to remain aware of long-term mortality and morbidity after GH treatment.

미숙아들의 출생 체중에 영향을 주는 요인 (Factors influencing birth weight premature infants)

  • 엄지아;정희진;허재원;홍수영
    • Clinical and Experimental Pediatrics
    • /
    • 제50권10호
    • /
    • pp.954-958
    • /
    • 2007
  • 목 적 : 본원에서 출생한 미숙아들을 대상으로 하여 이들 미숙아들 중에서 부당 경량아 출생과 관련이 있는 요인들에 대해 알아보고자 본 연구를 시행하였다. 방 법 : 2000년 1월부터 2006년 8월까지 출생한 재태 연령 26주 이상 35주 이하의 미숙아 1,010명을 대상으로 하였으며 이들과 이들의 모체의 의무기록을 후향적으로 조사하여 재태 연령, 출생 체중, 성별, 출생 순위, 산모의 나이 및 이전 유산 횟수 등에 관한 자료들을 수집하였고 부당 경량아 출생과 관련이 있는 요인들을 비교 분석하였다. 결 과 : 본 연구에서 미숙아들 중에서 여아에서 남아보다 부당 경량아 출생이 더 많은 것으로 나타났으며(P=0.042) 또한 산모의 나이가 20세 미만이거나 35세 이상인 경우에 부당 경량아 출생이 더 많은 것으로 나타났다(P=0.041). 미숙아의 출생 순위나 산모의 이전 유산 경력은 부당 경량아 출생과 통계학적인 관련성이 없는 것으로 나타났다(P=0.228, P=0.129). 결 론 : 출생 체중과 미숙아의 생존율과의 관련성을 생각해 보면 산모의 나이가 미숙아의 생존율과 관련이 있는 것으로 생각된다. 10대 임신을 줄이고 산모가 고령이 되기 전에 출산을 할 수 있도록 여러 사회적, 정책적인 뒷받침이 이루어진다면 미숙아들의 생존율을 높이고 더 나아가 건강한 정상 신생아 분만에도 큰 도움이 되리라 생각된다.

Comparison of postnatal catch-up growth according to definitions of small for gestational age infants

  • Huh, Jisun;Kwon, Ji Yoon;Kim, Hye Ryun;Lee, Eun Hee;Rhie, Young-Jun;Choi, Byung Min;Lee, Kee-Hyoung
    • Clinical and Experimental Pediatrics
    • /
    • 제61권3호
    • /
    • pp.71-77
    • /
    • 2018
  • Purpose: Small for gestational age (SGA) is confusingly defined as birth weight (BW) either below 3rd percentile or 10th percentile for infants. This study aimed to compare postnatal catch-up growth between SGA groups according to different definitions. Methods: Data of 129 infants born with BW below the 10th percentile and admitted to Korea University Anam Hospital and Ansan Hospital were retrospectively reviewed. Height and weight were measured at 6, 12, and 24 months. Results were compared between group A (BW: <3rd percentile) and group B (BW: 3rd-10th percentile). Results: Group A included 66 infants and group B included 63. At age 6 months (n=122), 62.9% of group A and 71.7% (P=0.303) of group B showed catch-up growth in weight. At 6 months (n=69), 55.9% of group A and 80.0% of group B (P<0.05) showed catch-up growth in height. At 12 months (n=106), 58.5% of group A, and 75.5% (P=0.062) of group B showed catch-up growth in weight. At 12 months (n=75), 52.8% of group A and 64.1% of group B (P=0.320) showed catch-up growth in height. Up to age 24 months, 66.7%/80.0% in group A and 63.6%/80.0% in group B showed catch-up growth in weight/height. Conclusion: Despite different definitions, there were no significant differences between the two SGA groups in postnatal catch-up growth up to age 24 months, except for height at 6 months. Compared to infants with appropriate catch-up growth, low gestational age and BW were risk factors for failed catch-up growth at 6 months.

부당경량아. 크기만 작은가? (Consequences of being born small for gestational age : More than being small)

  • 유은경
    • Clinical and Experimental Pediatrics
    • /
    • 제52권2호
    • /
    • pp.152-158
    • /
    • 2009
  • Reduced fetal growth is independently associated with increased risk of health problems in later life, particularly type 2 diabetes and cardiovascular diseases. Insulin resistance appears to be a key component underlying these metabolic complications. It is suggested that detrimental fetal environment may program insulin resistance syndrome. An insulin-resistant genotype may also result in both low birth weight and insulin resistance syndrome, and it is likely that the association of low birth weight with insulin resistance is the result of both genetic and environmental factors. Early postnatal rapid catch-up growth is closely related to risk for subsequent metabolic diseases. Fat mass is strikingly reduced in neonates born small for gestational age (SGA), and recent data suggest that insulin resistance seen in catch-up growth is related to the disproportionate catch-up in fat mass compared with lean mass. Endocrine disturbances are also recognized in SGA children, but overt clinical problems are infrequent in childhood. Cognitive impairment is reported in some children born SGA, especially those who do not show catch-up growth, in whom early neurodevelopmental evaluation is required. Breast feeding, also known to be protective against the long-term risk of obesity, may prevent some intellectual impairment in SGA children. Calorie-dense feeding does not seem to be appropriate in SGA infants. We must balance the positive effect of nutrition on neural development against rapid fat deposition and the future risk of insulin resistance.