Children Born Small for Gestational Age: Differential Diagnosis, Molecular Genetic Evaluation, and Implications

Martijn J. J. Finken, Manouk van der Steen, Carolina C. J. Smeets, Marie J. E. Walenkamp, Christiaan de Bruin, Anita C. S. Hokken-Koelega, Jan M. Wit

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Children born small for gestational age (SGA), defined as a birth weight and/or length below -2 SD score (SDS), comprise a heterogeneous group. The causes of SGA are multifactorial and include maternal lifestyle and obstetric factors, placental dysfunction, and numerous fetal (epi)genetic abnormalities. Short-term consequences of SGA include increased risks of hypothermia, polycythemia, and hypoglycemia. Although most SGA infants show catch-up growth by 2 years of age, ∼10% remain short. Short children born SGA are amenable to GH treatment, which increases their adult height by on average 1.25 SD. Add-on treatment with a gonadotropin-releasing hormone agonist may be considered in early pubertal children with an expected adult height below -2.5 SDS. A small birth size increases the risk of later neurodevelopmental problems and cardiometabolic diseases. GH treatment does not pose an additional risk.
Original languageEnglish
Pages (from-to)851-894
JournalEndocrine Reviews
Issue number6
Publication statusPublished - 2018

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