Growth and body composition in very young SGA children

Abstract

Infants with a very low birth weight are at risk of a reduced number of nephrons predisposing to kidney disorder, hypertension, and metabolic syndrome. Approximately 3% of infants are born small for gestational age (SGA), defined as birth weight and/or length at least 2 SD below the mean for gestational age (GA), independently of whether these children are born prematurely or at term. About 10% of these children do not show postnatal catch-up growth and remain of short stature during childhood. Most of these infants are not growth hormone (GH)-deficient, but may have GH resistance. Although GH-resistant, the majority of patients benefit from GH therapy, normalize height during childhood, maintain a normal growth velocity during puberty, and attain a normal adult height. To date, GH has been shown to be safe and no significant adverse effects have been demonstrated. Children with congenital chronic kidney disease (CKD) are born with subnormal birth weight and length and about 25% are born SGA. Shortness and need for GH treatment is highly correlated with weight at birth and gestational age. Primary renal disorders modify the response to GH treatment. Analysis of whether SGA is an additional risk factor for CKD regarding the development of hypertension, metabolic syndrome and cardiovascular complications is required.

Zalecenia Sekcji Pediatrycznej Polskiego Towarzystwa Nadciśnienia Tętniczego dotyczące postępowania diagnostycznego i terapeutycznego w nadciśnieniu tętniczym u dzieci i młodzieży

“…Arterial hypertension is also increasingly important in children and adults born prematurely, especially before 33 weeks of gestation and in children born with intrauterine hypotrophy (small for gestational age, SGA) [1][2][3].…”

The Importance of the Prenatal Environment in Behavioral Genetics: Introduction to Special Issue

“…Such studies have historically examined the Dutch Famine Birth Cohort, which consists of men and women born as term singletons in the western part of The Netherlands during or immediately following the Dutch Famine of 1944–1945 (de Rooij et al 2010; Stein et al 1972). The use of this particular cohort allowed the opportunity to examine the effects of one particular adverse exposure—starvation during pregnancy, even as a function of trimester—which was associated with outcomes such as schizophrenia, type 2 diabetes mellitus, cardiovascular disease, other metabolic disorders, and decreased cognitive function later in life (Argente et al 2010; Barker and Clark 1997; de Rooij et al 2010). …”

Birthweight is associated with DNA promoter methylation of the glucocorticoid receptor in human placenta

“…9 High birthweight, as well, has been shown to have serious adverse health outcomes in both developing children and later in life. 10 Previous studies have shown high birthweight as a risk factor for insulin resistance, 11 obesity 12 and cancers such as leukemia and breast, prostate and colon cancers.…”