Children born small for gestational age

Abstract

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 mg/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.