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Small for gestational age: Growth and puberty issues

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Abstract

Context

Small for gestational age infants have multifold increased risk of growth failure and adulthood disorders. Those who experience rapid catch up growth are at risk of developing metabolic syndrome, whereas those without catch up may end up with short stature. These children are also prone to an altered pubertal development.

Need and Purpose

Scarcity of literature, lack of published guidelines on the follow-up and management plan of children born with small for gestational age.

Evidence Acquisition

Literature search in PubMed was conducted with regard to epidemiology, growth and puberty, comorbidities, its pathogenesis and management in small for gestational age, with particular relevance for developing countries. An algorithm for follow-up of these children is outlined, based on available empiric data.

Conclusions

Being born small for gestational age predisposes to many metabolic and pubertal disorders. Special emphasis is needed for early detection and management through early surveillance in growth clinics, and regular follow-up to prevent associated comorbidities.

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References

  1. Alkalay AL, Graham Jr JM, Pomerance JJ. Evaluation of neonates born with intrauterine growth retardation: review and practice guidelines. J Perinatol. 1998;18:142–51.

    CAS  PubMed  Google Scholar 

  2. Clayton PE, Cianfarani S, Czernichow P, Johannsson G, Rapaport R, Rogol A. Management of the child born small for gestational age through to adulthood: A Consensus Statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society. J Clin Endocrinol Metab. 2007;92:804–10.

    Article  CAS  PubMed  Google Scholar 

  3. Lee PA, Chernausek SD, Hokken-Koelega AC, Czernichow P. International Small for Gestational Age Advisory Board Consensus Development Conference Statement: Management of the short child born small for gestational age. Pediatrics. 2001;111:1253–61.

    Article  Google Scholar 

  4. Karlberg J, Albertsson-Wikland K. Growth in full-term small for gestational age infants: from birth to final height. Pediatr Res. 1995;38:733–9.

    Article  CAS  PubMed  Google Scholar 

  5. Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A. Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. The Vermont Oxford Network. Am J Obstet Gynecol. 2000;182:198–206.

    Article  CAS  PubMed  Google Scholar 

  6. Saenger P, Czernichow P, Hughes L, Reiter E. Small for gestational age: Short stature and beyond. Endocrine Rev. 2007;28:219–51.

    Article  CAS  Google Scholar 

  7. Barker DJ, Osmond C, Forse´n TJ, Kajantie E, Eriksson JG. Trajectories of growth among children who have coronary events as adults. N Engl J Med. 2005;353:1802–9.

    Article  CAS  PubMed  Google Scholar 

  8. Verkauskiene R, Petraitiene I, Albertsson-Wikland K. Puberty in children born small for gestational age. Horm Res Paediatr. 2013;80:69–77.

    Article  CAS  PubMed  Google Scholar 

  9. Rapaport R, Tuvemo T. Growth and growth hormone in children born small for gestational age. Acta Paediatr. 2005;94:1348–55.

    Article  PubMed  Google Scholar 

  10. Bhargava SK, Ramji S, Srivastava V, Sachdev HPS, Kapani V, Datta V. Growth and sexual development of low birth weight children: A 14 year follow up. Indian Pediatr. 1995;32:963–70.

    CAS  PubMed  Google Scholar 

  11. Kushwaha KP, Singh YD, Bhatia VM, Gupta Y. Clinical assessment of nutritional status (CANS) in term newborns and its relation to outcome in neonatal period. J Neonatol. 2004;18:1.

    Google Scholar 

  12. Mehta S, Tandon A, Dua T, Kumari S, Singh SK. Clinical assessment of nutritional status at birth. Indian Pediatr. 1998;35:423–8. National Neonatal-Perinatal Database, NNPD Network. Indian Council of Medical Research. 2002-2003:25. Available from: http:/www.newbornwhocc.org/pdf/nnpd_report_2002-03. Accessed October 15, 2014.

    CAS  PubMed  Google Scholar 

  13. Narang A, Chaudhari MK, Kumar P. Small for gestational age babies: Indian scene. Indian J Pediatr. 1997;64:221–4.

    Article  CAS  PubMed  Google Scholar 

  14. Soto N, Bazaes RA, Pena V, Salazar T, Avila A, Iniguez G, et al. Insulin sensitivity and secretion are related to catch-up growth in small-for-gestational-age infants at age 1 year: results from a prospective cohort. J Clin Endocrinol Metab. 2003;88:3645–50.

    Article  CAS  PubMed  Google Scholar 

  15. Chellakooty M, Juul A, Boisen KA, Damgard IN, Kai CM, Schimdt IM, et al. A Prospective study of serum insulin like growth factor (IGF-1) and IGF binding protein-3 in 942 healthy infants: associations with birth weight, gender, growth velocity and breast feeding. J Clin Endocrinol Metab. 2006;91:820–6.

    Article  CAS  PubMed  Google Scholar 

  16. Hokken-Koelega AC, De Ridder MA, Lemmen RJ, Den Hartog H, De Muinck Keizer-Schrama SM, Drop SL. Children born small for gestational age: Do they catch up? Pediatr Res. 1995;38:267–71.

    Article  CAS  PubMed  Google Scholar 

  17. Albertsson-Wikland K, Boquszewski M, Karlberg J. Children born small-for-gestational age: Postnatal growth and hormonal status. Horm Res. 1998;49:7–13.

    Article  CAS  Google Scholar 

  18. Chaudhari S, Otiv M, Hoge M, Pandit A, Mote A. Growth and sexual maturation of low birth weight infants at early adolescence. Indian Pediatr. 2008;45:191–8.

    PubMed  Google Scholar 

  19. Rustogi D. To estimate Insulin like growth factor-1 (IGF-1) and insulin levels in small for gestational age (SGA) at the age of 12–18 months [MD thesis]. India: University of Delhi; 2011.

    Google Scholar 

  20. Gupta A. Evaluation of serum adiponectin levels at 15–18 months of age amongst those born term small for gestational age [MD thesis]. India: University of Delhi; 2013.

    Google Scholar 

  21. Tanaka T, Suwa S, Yokoya S, Hibi I. Analysis of linear growth during puberty. Acta Paediatr Scand Suppl. 1988;347:25–9.

    CAS  PubMed  Google Scholar 

  22. Deng HZ, Deng H, Su Z, Li YH, Ma HU, Chen HS, et al. Insulin resistance and adiponectin levels are associated with height catch-up growth in pre-pubertal Chinese individuals born small for gestational age. Nutr Metab. 2012;9:107.

    Article  CAS  Google Scholar 

  23. Ibanez L, Potau N, Zampolli M, Rique S, Saenger P, Carrascosa A. Hyperinsulinemia and decreased insulinlike growth factorbinding protein-1 are common features in prepubertal and pubertal girls with a history of premature pubarche. J Clin Endocrinol Metab. 1997;82:2283–8.

    CAS  PubMed  Google Scholar 

  24. Jaquet D, Deghmoun S, Chevenne D, Czernichow P, Levy-Marchal C. Low serum adiponectin levels in subjects born small for gestational age: impact on insulin sensitivity. Int J Obes. 2006;30:83–7.

    Article  CAS  Google Scholar 

  25. Neville KA, Walker JL. Precocious pubarche is associated with SGA, prematurity, weight gain, and obesity. Arch Dis Child. 2005;90:258–61.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Ong K, Kratzsch J, Kiess W, Dunger D. Circulating IGF-I levels in childhood are related to both current body composition and early postnatal growth rate. J Clin Endocrinol Metab. 2002;87:1041–4.

    Article  CAS  PubMed  Google Scholar 

  27. Hokken-Koelega AC. Timing of puberty and fetal growth. Best Pract Res Clin Endocrinol Metab. 2002;16:65–71.

    Article  CAS  PubMed  Google Scholar 

  28. Leger J, Levy-Marchal C, Bloch J, Pinet A, Chevenne D, Porquet D, Collin D, Czernichow P. Reduced final height and indications for insulin resistance in 20-year-old born small for gestational age: regional cohort study. BMJ. 1997;315:341–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Sloboda DM, Hart R, Doherty DA, Pennell CE, Hickey M. Age at menarche: influences of prenatal and postnatal growth. J Clin Endocrinol Metab. 2007;92:46–50.

    Article  CAS  PubMed  Google Scholar 

  30. Ibanez L, Jimenez R, de Zegher F. Early pubertymenarche after precocious pubarche: relation to prenatal growth. Pediatrics. 2006;117:117–21.

    Article  PubMed  Google Scholar 

  31. Persson I, Ahlsson F, Ewald U, Tuvemo T, Qingyuan M, von Rosen D, et al. Influence of perinatal factors on the onset of puberty in boys and girls: implications for interpretation of link with risk of long term diseases. Am J Epidemiol. 1999;150:747–55

    Article  CAS  PubMed  Google Scholar 

  32. Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM. Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993;36:62–7.

    Article  CAS  PubMed  Google Scholar 

  33. Jaquet D, Deghmoun S, Chevenne D, Collin D, Czernichow P, Levy-Marchal C. Dynamic change in adiposity from fetal to postnatal life is involved in the metabolic syndrome associated with reduced fetal growth. Diabetologia. 2005;48:849–55.

    Article  CAS  PubMed  Google Scholar 

  34. Ibanez L, Potau N, Enriquez G, Marcos MV, de Zegher F. Hypergonadotrophinaemia with reduced uterine and ovarian size in women born small-for-gestational-age. Hum Reprod. 2003;18:1565–9.

    Article  PubMed  Google Scholar 

  35. Ibanez L, de Zegher F. Puberty after prenatal growth restraint. Horm Res. 2006; 65:112–5.

    Article  CAS  PubMed  Google Scholar 

  36. Van Pareren YK, Duivenvoorden HJ, Slijper FS, Koot HM, Hokken-Koelega AC. Intelligence and psychosocial functioning during long-term growth hormone therapy in children born small for gestational age. J Clin Endocrinol Metab. 2004; 89:5295–302.

    Article  PubMed  Google Scholar 

  37. Huisman J, Slijper FM, Sinnema G, Akkerhuis GW, Brugman-Boezeman AT. Good things come in small packages? Psychosocial aspects of small stature. Tijdschr Kindergeneeskd. 1992;60:139–46.

    CAS  PubMed  Google Scholar 

  38. Prasad HK, Khadilkar VV, Chiplonkar SA, Khadilkar AV. Growth of Short Children born small for gestational age and their response to growth hormone therapy. Indian Pediatr. 2013;50:497–9.

    Article  PubMed  Google Scholar 

  39. Lem AJ, van der Kaay DC, de Ridder MA, Bakker-van Waarde WM, van der Hulst FJ, Mulder JC, et al. Adult height in short children born SGA treated with growth hormone and gonadotropin releasing hormone analog: results of a randomized, dose-response GH trial. J Clin Endocrinol Metab. 2012;97:4096–105.

    Article  CAS  PubMed  Google Scholar 

  40. Ibanez L, Valls C, Ong K, Dunger DB, de Zegher F. Metformin therapy during puberty delays menarche, prolongs pubertal growth, and augments adult height: a randomized study in low-birth-weight girls with early normal onset of puberty. J Clin Endocrinol Metab. 2006;91:2068–73.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Maulana Azad Medical College (MAMC) and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, 110 002, New Delhi, India

    Sangita Yadav & D. Rustogi

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  1. Sangita Yadav
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  2. D. Rustogi
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Correspondence to Sangita Yadav.

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Yadav, S., Rustogi, D. Small for gestational age: Growth and puberty issues. Indian Pediatr 52, 135–140 (2015). https://doi.org/10.1007/s13312-015-0588-z

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  • DOI: https://doi.org/10.1007/s13312-015-0588-z

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