Vol. 38, No.5, 1995 Printed in U.S.A.Intrauterine growth retardation, or being small for gestational age (SGA), has a life-long impact on a fetus's potential for development and survival. The incidence and relative risk of short stature in children born SGA were studied using a Swedish healthy full-term (37-43 wk of gestation) singleton birth cohort (n = 3650) from Goteborg, followed from birth to final height at about 18 y of age. Most infants, defined as SGA on the basis of a birth length less than -2 standard deviation scores (SDS) below the mean (SGA L infants), showed catch-up growth during the first 6 mo after birth, and by 1 Y only 13.4% of the SGA L infants were below -2 SDS in height. This percentage decreased further during childhood to reach a value of 7.9% at 18 y of age. Although most SGA L infants have catch-up growth in early life, those who do not constitute 21% of short, prepubertal children. At 18 Y of age, 22% of the total short population were short at birth « -2 SDS), whereas when birth weight was used to define SGA, only 14% of the 18-y-old short population were light at birth. SGA L infants were found to have a 7-fold higher risk for short final stature (relative risk, 7.1; 95% confidence interval,

An update of the Swedish reference standards for weight, length, and head circumference at birth, for each week of gestational age, is presented. It is based on the total Swedish cohorts of infants born 1977-1981 (n = 475,588). A "healthy population" (79%) was extracted, using prospectively collected data. Weekly (28-42 weeks) grouped data for length and head circumference were well approximated by the normal distribution, but the distributions for birthweight were positively skewed. The original skewed distributions for birthweight were transformed, using the square root, resulting in distributions close to the Gaussian. For smoothing purposes, the weakly values for the mean and the standard deviation were both fitted by a third degree polynomial function. These functions also make possible the calculation of the continuous variable, standard deviation score, for individual newborn infants as well as a comparison of distributions between groups of infants. The reference values and charts presented here have two major advantages over the current Swedish ones: the sample size used is now sufficiently large at the lower gestational ages, so that empirically found variations can be used, and the skewness of the birth weight distribution has been taken into account. The use of the reference standards presented here improves and facilitates evaluation of size deviation at birth.

Severe acute respiratory syndrome (SARS) has been reported in 30 countries and regions, with a cumulative total of 8,099 probable cases and 774 deaths as of July 31, 2003, according to the World Health Organization. In Hong Kong, People's Republic of China, 1,755 SARS cases and 299 deaths had occurred as of September 22, 2003. The authors analyzed data from the Department of Health, Hong Kong SAR. The data series includes details regarding sex, age, and chronic disease history. Using data from early March to September 22, 2003, the authors found that males had a significantly (p < 0.0001) higher case fatality rate than females did, 21.9% versus 13.2%; the relative risk was 1.66 (95% confidence interval (CI): 1.35, 2.05), and it was 1.62 (95% CI: 1.21, 2.16) after adjustment for age. Subgroup analysis was conducted by excluding health care workers (n = 386) from the analysis. The overall crude relative risk of mortality was 1.41 (95% CI: 1.15, 1.74), and the adjusted relative risk was 1.48 (95% CI: 1.10, 2.00). Thus, among SARS patients, males may be more severely affected by the disease than females are. This finding could be related to a nonuniform case definition of SARS disease, a different treatment regimen, a past smoking history, work-environment factors, or gender-specific immune-defense factors, for instance.