The incidence of perinatal disease and perinatal mortality in small for gestational age infants increased significantly. This group of people is prone to a variety of long-term metabolic diseases and cardiovascular diseases, and is also prone to growth retardation and neurodevelopmental delay, which will seriously affect the long-term quality of life of children. The article studies the neurodevelopmental outcomes of small-for-gestational-age infants. By reviewing and sorting out previous literature, the neurodevelopmental disorders of small-for-gestational-age infants are analyzed according to five aspects: intellectual development, motor development, language development, sensory development, and mental illness. The classification and summary were carried out, and the influencing factors of neurodevelopmental disorders of SGA were also evaluated, so as to provide reference for promoting the improvement of neurodevelopmental outcomes of small-for-gestational-age infants.
Infant, Newborn ; Pregnancy ; Female ; Child ; Infant ; Humans ; Gestational Age ; Quality of Life ; Infant, Small for Gestational Age ; Fetal Growth Retardation/epidemiology*

Objective: To analyze the physical growth of preterm infants with different intrauterine growth patterns. Methods: A total of 10 856 preterm infants who were born in various districts of Haikou City from October 1st, 2015 to June 1st, 2021 and received regular health care and management were retrospectively enrolled. The preterm infants were divided into appropriate for gestational age (AGA), small for gestational age (SGA) and large for gestational age (LGA) groups according to different intrauterine growth patterns. The general characteristics of preterm infants in different groups were compared by H test (Kruskal and Wallis) or Chi-squared test. And the developmental curves were plotted by local regression (LOESS) with their physical growth indexes. Results: Of the 10 856 preterm infants, 6 317 were boys and 4 539 were girls. The gestational age at birth was 35 (34, 36) weeks, and the birth weight was 2.5 (2.1, 2.8) kg. There were 754 (6.9%) SGA, 9 301 (85.7%) AGA, and 801 (7.4%) LGA preterm infants. All preterm infants were followed up until 18 months of corrected age. The birth weight of the SGA group was lower than that of the AGA and LGA groups (Z=2 274.93, P<0.001). The proportion of exclusive breastfeeding at the first health care interview was higher in the AGA group (68.6% (6 378/9 301)) than in the SGA group (62.9% (474/754)) (χ²=13.82, P=0.003). The LOESS curving fitting showed that the weight and height of the preterm infants in all the 3 groups increased rapidly during 0-6 months of corrected age. The regression prediction values of weight for age Z-score (WAZ), height for age Z-score (HAZ) and weight for height Z-score (WHZ) were around 0 s, while the regression prediction values of these three indicators in SGA were all below 0 s but greater than -1 s. The rates of low birth weight, growth retardation and wasting during 0-17 months of corrected age were 0.3% (16/4 838)-1.9% (47/2 506), 0.4% (18/4 838) -2.4% (51/2 124), and 2.1% (88/4 135) -4.4% (214/4 838) in AGA groups, and 0 (0/296) -1.0% (2/199), 0 (0/341) -1.6% (3/186) and 1.0% (2/199) -2.6% (9/341) in LGA group, whereas 7.6% (25/330) -16.8% (28/167), 5.2% (17/330)-10.6%(32/303) and 3.9% (3/77) -12.6% (21/167) in SGA group. In addition, the monthly growth of weight and height of preterm infants in all the 3 groups decreased with the increasing age, and the monthly weight gain. The length increment was 4.0 cm/month during corrected 0-2 month of age and 2.4 cm/month during corrected 2-5 month of age in the SGA preterm infants. Conclusions: Most of the preterm infants could have an appropriate catch-up growth, but the growth and development in the SGA preterm infants lags behind that of their AGA and LGA peers. The physical growth of SGA premature infants should be paid more attention to, to timely correct the growth deviations.
Birth Weight ; Child, Preschool ; Female ; Fetal Growth Retardation ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; Infant, Premature ; Infant, Small for Gestational Age ; Male ; Retrospective Studies

Objective: To analyse the efficacy of recombinant human growth hormone (rhGH) treatment in children born small for gestational age (SGA) with syndormic and non-syndormic short stature. Methods: The clinical data of 59 children born SGA who were diagnosed as short stature and admitted to the Center of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital from July 2012 to June 2021 were collected and analyzed. According to the 2019 consensus on short stature, they were divided into syndromic group and non-syndromic group. Before treatment and 6, 12, 18 and 24 months after treatment, height standard deviation score (Ht-SDS), difference of height standard deviation (∆Ht-SDS) and homeostasis model assessment-insulin resistance index (HOMA-IR) were compared between groups, while Ht-SDS and HOMA-IR were compared before and after treatment. Independent t test or Kruskal-Wallis test were used for comparison between the 2 groups, and paired t test or Mann-Whitney U test were used for the intra-group comparison. Results: Among the 59 cases, 37 were males and 22 females, aged (5.5±2.3) years. There was no significant difference in Ht-SDS after 12 months of treatment between 2 groups (0.9±0.4 vs. 1.2±0.4, t=1.68, P=0.104) or in height SDS after 24 months of treatment (1.4±0.7 vs. 1.9±0.5, t=1.52, P=0.151). After 12 months of treatment, the insulin resistance index of the non-syndromic group was significantly higher than that of the syndromic group (2.29 (1.43, 2.99) vs. 0.90 (0.55, 1.40), Z=-2.95, P=0.003). There were significant differences in Ht-SDS between 6 months and before treatment, 12 months and 6 months in syndromic type (Z=7.65, 2.83 P<0.001, P=0.020), but all were significant differences in non-syndromic type between 6 months and before treatment, 12 months and 6 months, 18 months and 12 months, 24 months and 18 months (Z=11.95, 7.54, 4.26, 3.83, all P<0.001). Conclusion: The efficacy of rhGH treatment in children born SGA is comparable between syndromic and non-syndromic short stature cases, but non-syndromic children treated with rhGH need more frequent follow-up due to the risk of insulin resistance.
Child ; Female ; Humans ; Male ; Body Height ; Gestational Age ; Human Growth Hormone/therapeutic use* ; Infant, Small for Gestational Age ; Insulin ; Insulin Resistance ; Recombinant Proteins ; Child, Preschool

Intrauterine growth restriction (IUGR) is caused by many factors, and most newborns with IUGR are small for gestational age (SGA). SGA infants have a relatively high risk of death and disease in the perinatal period, and the nervous system already has structural changes in the uterus, including the reduction of brain volume and gray matter volume, accompanied by abnormal imaging and pathological changes. IUGR fetuses undergo intrauterine blood flow redistribution to protect brain blood supply, and there are still controversies over the clinical effect of brain protection mechanism. SGA infants have a relatively high risk of abnormal cognitive, motor, language, and behavioral functions in the neonatal period and childhood, and preterm infants tend to have a higher degree of neurological impairment than full-term infants. Early intervention may help to improve the function of the nervous system.
Brain ; Child ; Female ; Fetal Growth Retardation ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Pregnancy

OBJECTIVETo investigate the renal function of small-for-gestational-age (SGA) infants at the early stage after birth.

METHODSA total of 40 preterm SGA infants, 33 full-term SGA infants, 80 preterm appropriate-for-gestational-age (AGA) infants, and 33 full-term AGA infants were included in this study. The following indices were compared between the SGA infants and AGA infants within 48 hours after admission: blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR), blood pressure, urine volume per body weight, and proteinuria.

RESULTSThe preterm SGA group had a significantly lower BUN level than the preterm AGA group (P<0.05). However, there were no significant differences in SCr level, eGFR, and blood pressure between the two groups (P>0.05). The full-term SGA group had a significantly higher SCr level and a significantly lower eGFR than the full-term AGA group (P<0.05). However, there were no significant differences in BUN level and blood pressure between the two groups (P>0.05). There was no significant difference in urine volume per body weight between the preterm SGA and preterm AGA groups (P>0.05) and between the full-term SGA and full-term AGA groups (P>0.05). There was no significant difference in the incidence of proteinuria between the preterm SGA and preterm AGA groups (P>0.05). Proteinuria was not present in the SGA full-term and AGA full-term groups.

CONCLUSIONSSCr and eGFR can be used as the diagnostic indices for early renal damage of SGA infants. The renal function is worse in full-term SGA infants than in full-term AGA infants.

Creatinine ; blood ; Female ; Fetal Growth Retardation ; physiopathology ; Glomerular Filtration Rate ; Humans ; Infant ; Infant, Small for Gestational Age ; physiology ; Kidney ; physiology ; Male ; Retrospective Studies

OBJECTIVETo investigate whether fetal growth restriction (FGR) has an adverse effect on white matter development.

METHODSA total of 28 full-term small for gestational age (SGA) infants were enrolled as study subjects and 15 full-term appropriate for gestational age infants were enrolled as control group. Conventional head magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were performed for all infants. The white matter was divided into 122 regions. The two groups were compared in terms of fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity of different brain regions.

RESULTSCompared with the control group, the SGA group had a significantly lower fractional anisotropy in 16 brain regions (P<0.01), a significantly higher mean diffusivity in 7 brain regions (P<0.05), a significantly higher axial diffusivity in 8 brain regions (P<0.05), and a significantly higher radial diffusivity in 16 brain regions (P<0.05).

CONCLUSIONSFGR may cause abnormalities in the maturity and integrity of white matter fiber tracts.

Diffusion Tensor Imaging ; methods ; Female ; Fetal Growth Retardation ; diagnostic imaging ; physiopathology ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Male ; White Matter ; diagnostic imaging ; embryology

OBJECTIVETo investigate the physical growth and psychomotor development of very low birth weight (VLBW) preterm infants in the first year after birth and related influencing factors.

METHODSA total of 61 VLBW preterm infants received growth and development monitoring for 12 months. Z score was used to evaluate parameters for physical growth, and Denver Development Screen Test (DDST) was used for development screening.

RESULTSAmong the 61 VLBW preterm infants, 27 (44.3%) were small-for-gestational-age (SGA) infants, and 34 (55.7%) were appropriate-for-gestational-age (AGA) infants. During the 1-year follow-up, the median weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), head circumference-for-age Z-score (HCZ), and weight-for-height Z score (WHZ) were >-1 SD in all age groups. The peaks of body mass index-for-age Z-score (BAZ) and WHZ appeared at 1 month of corrected age. At a corrected age of 40 weeks, the incidence rates of underweight, growth retardation, emaciation, microcephalus, overweight, and obesity were 15%, 16%, 11%, 13%, 20%, and 10%, respectively. Compared with those with a corrected age of 40 weeks, the infants with a corrected age of 6 months or 9-12 months had a significantly reduced incidence rate of overweight (3%) (P<0.05). Up to 1 year after birth, 15 infants (25%) had abnormal developmental quotient (DQ). The SGA group had a significantly higher incidence rate of abnormal DQ than the AGA group (P<0.05). SGA was the independent risk factor for retarded growth in the first year after birth in VLBW preterm infants.

CONCLUSIONSVLBW preterm infants experience an obvious growth deviation within 3 months of corrected age. Within the first year after birth, the proportion of infants with abnormal DQ screened by DDST is high.

Body Weight ; Child Development ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Infant, Very Low Birth Weight ; growth & development ; Male

OBJECTIVETo investigate the efficacy and safety of different doses of recombinant human growth hormone (rhGH) in the treatment of short stature in children born small for gestational age (SGA).

METHODSA total of 37 children with short stature born SGA were enrolled, and based on the dose of rhGH treatment, they were divided into low-dose rhGH group (0.1-0.15 IU/kg daily) and high-dose rhGH group (0.16-0.2 IU/kg daily). The changes in height standard deviation score (ΔHtSDS), height velocity (HV), serum levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3), and fasting blood glucose at 3, 6, 9, 12, and 24 months after treatment were compared between the two groups.

RESULTSΔHtSDS and HV both increased after the treatment with high- and low-dose rhGH, but ΔHtSDS and HV in the high-dose rhGH group were significantly higher than in the low-dose rhGH group 9, 12 and 24 months after treatment (P<0.05). Both high- and low-dose rhGH treatment increased serum levels of IGF-1 and IGFBP-3. Serum levels of IGF-1 and IGFBP-3 were positively correlated with HtSDS in both groups. One child each in the high- and low-dose rhGH groups experienced transient slight increase in fasting blood glucose (6.1 mmol/L). There were no cases of abnormal thyroid function.

CONCLUSIONSrhGH has good efficacy in the treatment of short stature in children born SGA, with few adverse events, and high-dose rhGH has some advantages over low-dose rhGH.

Body Height ; Child ; Child, Preschool ; Female ; Growth Disorders ; blood ; drug therapy ; Human Growth Hormone ; therapeutic use ; Humans ; Infant, Small for Gestational Age ; Insulin-Like Growth Factor Binding Protein 3 ; blood ; Insulin-Like Growth Factor I ; analysis ; Male ; Recombinant Proteins ; therapeutic use

OBJECTIVETo observe catch-up growth in height within two years of birth in infants of different sexes, gestational ages, and birth weights with intrauterine growth retardation (IUGR).

METHODSFollow-up was performed on 294 IUGR infants and 300 healthy full-term infants at 4, 6, 9, 12, 15, 18, 21 and 24 months after birth to measure the height, calculate the height increase and compare the two groups with respect to height increase.

RESULTSThe success rates of catch-up growth in height were 72.2% in male infants and 71.5% in female infants (P=0.90), and were 77.4% in preterm small-for-gestational age (SGA) infants and 68.6% in full-term SGA infants (P=0.11). Success rates of catch-up growth in height in infants with birth weights between 1500-2499 g was higher than in those with birth weights of <1500 g and ≥2500 g (P<0.01). The male infants showed significant catch-up growth at 4, 6, 18, 21 and 24 months after birth, while significant catch-up growth was found in female infants at 4, 6, 9, 12 and 21 months after birth. Of the male infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 6 and 9 months after birth. Of the female infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 4 and 18 months after birth. For both male and female infants, height increase at 4 months after birth was significantly greater in those with birth weights of <1500 g than in those with birth weights of ≥2500 g. For male infants, height increases at 4, 6, 18, 21 and 24 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g. For female infants, height increases at 4, 6, 9, 12 and 21 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g.

CONCLUSIONSThe catch-up growth in height within two years of birth in infants with IUGR occurs mainly in the first year after birth in female infants, but can be seen in the first six months and the second year after birth in male infants. Preterm SGA infants better catch-up growth than full-term SGA infants, and infants with birth weights of below 1500 g and between 1500-2499 g show better catch-up growth than those with birth weights of ≥2500 g.

Birth Weight ; Body Height ; Female ; Fetal Growth Retardation ; physiopathology ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Male

OBJECTIVEAs the intrauterine environment can affect childhood growth and development, this study aims to understand the relationship between birth gestational age, birth weight and physique development in 9 to 15-year-old children by a cross sectional investigation in Chengdu City, Sichuan Province.

METHODSA total of 7194 9 to 15-year-old school children were classified according to birth gestational age and birth weight: small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA). Their heights and weights were measured. Parents completed a questionnaire.

RESULTSThe prevalence of SGA was 6.23% (448 cases), and 5.13% of children in the SGA group did not undergo "catch-up growth" (lower than -2 SD). The mean height in these children at various stages was significantly lower than in the AGA group (P<0.05). The prevalence of LGA was 18.06% (1299 cases). A total of 179 children (13.78%) were found to be overweight and 57 children (4.39%) were found to be obese in the LGA group. The mean weight in the LGA group at various stages was significantly higher than in the AGA group (P<0.05).

CONCLUSIONSHeight and weight development in children born SGA and LGA are different from normal children. More attention should be given to aspects of height and weight development in these school children.

Adolescent ; Birth Weight ; Body Height ; Body Weight ; Child ; Child Development ; Female ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; growth & development ; Male