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Newborns who do not reach a weight appropriate for their gestational age and sex can be classified in different ways. This article defines the concepts of small for gestational age (SGA) and intrauterine growth restriction, as well as the underlying causes of these conditions, with the goal of establishing consensus definitions for these patients, in whom treatment with growth hormone throughout childhood may be indicated and who may be at risk of developing endocrine or metabolic disorders in puberty and adulthood. Most SGA children experience spontaneous catch-up growth that is usually completed by age 2 years. In SGA children who remain short, treatment with recombinant human growth hormone is effective, increasing adult height. Small for gestational age infants with rapid catch-up growth and marked weight gain are at increased risk of premature adrenarche, early puberty, polycystic ovary syndrome (girls), insulin resistance and obesity, all of which are risk factors for type 2 diabetes and metabolic syndrome in adulthood. The SGA status can affect different areas of neurodevelopment and manifest at different stages in life; neurodevelopmental outcomes are better in SGA infants with spontaneous catch-up growth. Due to the potential risks associated with SGA, adequate characterization of these patients at birth is imperative, as it allows initiation of appropriate follow-up and early detection of abnormalities. Resumen: Los recién nacidos que no alcanzan un peso acorde con su edad gestacional y sexo se pueden clasificar de distintos modos. En este artículo se definen los conceptos de pequeño para la edad gestacional (PEG) y crecimiento intrauterino reducido, así como las causas que las determinan con el objetivo de consensuar las definiciones en este tipo de pacientes que puedan ser susceptibles de tratamiento con hormona de crecimiento a lo largo de su infancia, así como de desarrollar patología endocrinológica en la pubertad y edad adulta. La mayoría de los niños PEG experimentan un crecimiento recuperador espontáneo que suele completarse a los dos años. En los PEG que no lo realizan, el tratamiento con hormona de crecimiento humana recombinante es efectivo, aumentando su talla adulta. Los PEG con crecimiento recuperador rápido y marcado en peso tienen mayor riesgo de desarrollar adrenarquia precoz, pubertad adelantada, síndrome del ovario poliquístico (niñas), resistencia a la insulina, y obesidad; predisponiendo al desarrollo de diabetes tipo 2 y síndrome metabólico en la edad adulta. La condición de PEG puede afectar diferentes áreas del neurodesarrollo y manifestarse éstas en diferentes etapas de la vida; los PEG con crecimiento recuperador espontáneo tienen mejor pronóstico neurológico. Los posibles riesgos descritos asociados a la condición de PEG hacen imperativo la adecuada caracterización de estos pacientes al nacimiento, que permitirá su seguimiento prospectivo y la detección precoz de alteraciones.

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Introduction: Preterm newborns (PN) have a higher risk of thyroid dysfunction than term newborns (TN). This condition may go unnoticed in neonatal screening due to a late elevation of thyrotropin (TSH) in these patients. Objective: Evaluate thyroid function in the second week of life in PN of < 32 weeks gestation (WG), and to identify factors associated to its alteration. Patients and methods: A retrospective study was performed in neonates of < 32 weeks gestation (WG), in whom thyroid function was determined. An analysis was performed on thyroxine (T4L) and TSH levels, as well as their association with perinatal and neonatal outcomes. Results: The study included a total of 358 patients with mean gestational age (GA) of 29.3 weeks, and mean birth weight (BW) 1127 grams. A linear correlation was found between T4L and BW (correlation coefficient (R) 0.356; p < 0.001) and GA (R = 0.442; p < 0.001). TSH values were associated with small for gestational age (SGA 5.3 mU/L [1.5-37]; non-SGA 2.89 mU/L [0.2-19.5]; p < 0.001), inotropic support (Yes 3.98 mU/L [0.6-22.9]; No 3.16 mU/L [0.2-37]; p = 0.019) and BW (R = -0.249; p < 0.001). Nine (2.5%) patients were treated with levothyroxine, of whom six were SGA. Conclusions: Thyroid function analysis in the second week of life helps to identify asymptomatic newborns with risk of thyroid dysfunction. SGA newborns are at higher risk of thyroid function alterations. Resumen: Introducción: El recién nacido (RN) prematuro (RNPT) tiene mayor riesgo de disfunción tiroidea que el recién nacido a término (RNAT). Esta alteración puede pasar desapercibida en el cribado neonatal por una elevación tardía de tirotropina (TSH) en estos pacientes. Objetivo: Evaluar la función tiroidea en la segunda semana de vida en RNPT menores a 32 semanas de gestación (SG) e identificar factores asociados con la alteración de esta. Pacientes y métodos: Estudio restrospectivo que incluye RNPT de igual o menos de 32 SG, a los que se realizó función tiroidea. Se analizaron los valores de tiroxina (T4L) y TSH y su relación con variables perinatales y de evolución neonatal. Resultados: Se presentaron 358 pacientes con edad gestacional (EG) mediana de 29,3 semanas y peso al nacimiento (PN) de 1.127 gramos. Se encontró correlación lineal entre T4L y el PN (coeficiente de correlación (R) 0,356; p < 0,001) y la EG (R = 0,442; p < 0,001). Los valores de TSH se asociaron con ser pequeño para la edad gestacional (PEG 5,3 mU/L [1,5 a 37]; no PEG 2,89 mU/L [0,2 a 19,5]; p < 0,001), al soporte inotrópico (Sí 3,98 mU/L [0,6 a 22,9]; No 3,16 mU/L [0,2 a 37]; p = 0,019) y al PN (R = -0,249; p < 0,001). Recibieron tratamiento sustitutivo con levotiroxina nueve pacientes (2,5%), seis de los cuales fueron PEG. Conclusiones: El análisis de la función tiroidea en la segunda semana de vida permite identificar RNPT asintomáticos con riesgo de presentar alteración de la función tiroidea. Los RN PEG tienen un riesgo más elevado de disfunción tiroidea.

Introduction: Several studies conclude that small for gestational age (SGA) children have a higher number of comorbidities, as well as a different hormonal profile compared to those with appropriate weight for gestational age (AGA). Thyroid hormones play an important role in growth and neurocognitive development. Thyroid function in SGA children is still not completely known. Objectives: To compare the thyroid function of SGA children during the first 2 years of life with that in publications on thyroid function in other groups of infants, such as AGA and premature children, using the same methodology. Methods: A cohort of 38 SGA children was obtained, in which the thyrotropin (TSH) values in blood were measured at different points in the development of the SGA child. The results were compared with a population of AGA children from Zaragoza and a population of premature children from Barcelona by comparing the means using a 2-tailed test. Results: A statistically significant difference (P

Newborns who do not reach a weight appropriate for their gestational age and sex can be classified in different ways. This article defines the concepts of small for gestational age (SGA) and intrauterine growth restriction, as well as the underlying causes of these conditions, with the goal of establishing consensus definitions for these patients, in whom treatment with growth hormone throughout childhood may be indicated and who may be at risk of developing endocrine or metabolic disorders in puberty and adulthood. Most SGA children experience spontaneous catch-up growth that is usually completed by age 2 years. In SGA children who remain short, treatment with recombinant human growth hormone is effective, increasing adult height. Small for gestational age infants with rapid catch-up growth and marked weight gain are at increased risk of premature adrenarche, early puberty, polycystic ovary syndrome (girls), insulin resistance and obesity, all of which are risk factors for type 2 diabetes and metabolic syndrome in adulthood. The SGA status can affect different areas of neurodevelopment and manifest at different stages in life; neurodevelopmental outcomes are better in SGA infants with spontaneous catch-up growth. Due to the potential risks associated with SGA, adequate characterization of these patients at birth is imperative, as it allows initiation of appropriate follow-up and early detection of abnormalities., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Background: small-for-gestational-age (SGA) newborns present a higher morbidity and mortality rate when compared to infants born appropriate for gestational age (AGA), as well as insufficient growth, with height far from their target and in some cases a low final height (< -2 SDs). Objective: the aim of this study was to determine when catch-up growth (CUG) in height occurs in these children, and which factors are associated with lack of CUG. Material and methods: this is a retrospective study of SGAs born between 2011 and 2015 in a secondary hospital. Anthropometric measurements were taken consecutively until CUG was reached, and fetal, placental, parental, newborn, and postnatal variables were studied. Results: a total of 358 SGAs were included from a total of 5,585 live newborns. At 6 and 48 months of life, 93.6 % and 96.4 % of SGAs achieved CUG, respectively. By subgroups, symmetric SGAs performed worse than asymmetric SGAs with CUG in 84 % and 92 % at 6 and 48 months of life, respectively. The same occurred in the subgroup of preterm SGAs with respect to term SGAs, with worse CUGs of 88.2 % and 91.2 % at 6 and 48 months of life, respectively. Prematurity, symmetrical SGA, intrauterine growth retardation (IUGR), preeclampsia, previous child SGA, perinatal morbidity, and comorbidity during follow-up were associated with absence of CUG. Conclusions: the majority of SGAs had CUG in the first months of life. The worst outcomes were for preterm and symmetric SGAs. [ABSTRACT FROM AUTHOR]

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Introduction: Introduction: human growth is the result of an interaction between genetic, hormonal, nutritional, and environmental factors. It is not yet fully understood what is predominant and decisive in determining an individual's weight and height. Objective: the aim of this study was to evaluate the cardiometabolic profile of exclusively breastfed children born small for gestational age (SGA). Methods: this is a prospective cohort study of children born at term who were classified as SGA, and as appropiate for gestational age (AGA), who were followed up to pre-school age. Anthropometric measures and body composition parameters were obtained. Breastfeeding duration was calculated in days, and achievement of catch up of weight was considered an increase in Z-score ≥ 0.67. The cardiometabolic profile was evaluated in the first month of life and repeated at pre-school age. At pre-school age, fasting blood glucose, insulin, HOMA-IR, and blood pressure were measured. Results: twenty SGA and 12 AGA children were studied. The mean duration of exclusive breastfeeding (EBF) was 180 days in both groups. Of SGA children, 85 % had recovery anthropometric parameters for age within the first six months, with a speed of weight gain significantly higher than the that of AGAs (p < 0.001). SGAs continued to be thinner and smaller than AGAs at pre-school age. There was no diagnosis of overweight or obesity in the studied sample, and no differences were foun between groups in laboratory tests. Conclusion: these findings suggest that EBF may confer protection until pre-school age in children born SGA, who are considered at higher risk for chronic non-communicable diseases. [ABSTRACT FROM AUTHOR]

La Restricción del Crecimiento Fetal (RCF) es un crecimiento anormal que se asocia a pronóstico adverso a corto, mediano y largo plazo. Los factores etiológicos pueden estar actuando sinérgicamente y por tanto el uso de múltiples parámetros para su identificación que está en relación a su presentación clínica y progresión dependiente de la edad gestacional y de su etiología. Se describen las presentaciones típicas de la RFC temprana y tardía y la necesidad de diferenciarlo del Pequeño constitucional normal (PCN).

Objetivos. Identificar Neonatos con Restricción del Crecimiento Intrauterino (RCIU) Tardío con doppler umbilical normal y evaluar el valor diagnóstico anteparto de un algoritmo multiparámetro. Materiales y métodos. Estudio analítico, observacional y retrospectivo y creación más evaluación preliminar de una prueba diagnóstica. Fueron seleccionados al azar 96 neonatos de 35 a 41 semanas sin anomalías. 23 Pequeños para la Edad Gestacional (PEG) según el método local de clasificación del crecimiento, 13 con peso adecuado para la edad gestacional (AEG) limítrofe (dentro de los 200 g sobre el percentil 10) y 60 con peso AEG sobre el percentil 25. Se identificaron 22 casos de RCIU (casos) y 74 no RCIU (controles) según una definición operativa pre establecida. Los valores estadísticos fueron calculados para pruebas diagnósticas simples con Epidat 3,1. Resultados. 22 de 96 neonatos(23 % ) fueron clasificados como RCIU; 16 de los 23 PEG (69,5 %); 6 de 13 AEG con peso limítrofe ( 46,2 %) y 0 de 60 AEG con peso mayor al percentil 25. La sensibilidad, especificidad, VPP, VPN, CP + y CP – global fue de 86,4 %; 95,9 %; 86,4 %; 95,9 %; 21,3 y 0,14 respectivamente. Sólo 4 de 22 (18%) casos de RCIU fueron diagnosticados como tal en el anteparto a diferencia de 19 de 22 ( 86,4 % ) mediante el uso del algoritmo diagnóstico. Conclusiones. El uso de un algoritmo diagnóstico multiparámetro mejora la identificación de RCIU en ≥ 35 semanas con doppler umbilical normal.

Copyright of Matronas Profesion is the property of Ediciones Mayo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Analizar la tasa de detección de fetos pequeños para la edad gestacional (PEG) y crecimiento intrauterino restringido (CIR) mediante exploración ecográfica. Método: Estudio retrospectivo de casos y controles. Recién nacidos (RN) de gestaciones únicas a término (entre la semana 37-42) en el Hospital Universitario San Cecilio entre 2009 y 2010. Grupo casos: 98 RN a término con peso al nacer < 2500 g, con peso fetal estimado (PFE) por ecografía en el III trimestre. Grupo control: 100 RN durante el mismo período con peso al nacer entre 3000-4000 g, con PFE por ecografía en el III trimestre obtenido de forma aleatoria. Resultados: La tasa de detección de CIR tipo I fue de un 11,1% con una incidencia del 0,1% y la tasa de detección de pequeños para edad gestacional fue de un 56,5% con una incidencia del 2% respecto al total de RN. Conclusión: En nuestra experiencia la EPF mediante ecografía en fetos con peso bajo el p10 tiene un error de 6% respecto al peso neonatal, esto permite una adecuada identificación de fetos con PEG y CIR.Objective: To analyze the detection rate of small for gestational age (SGA) fetuses and intrauterine growth restriction (IUGR) fetuses by ultrasound exploration. Methods: Cases and controls retrospective study. Material: Newborn (NB) of singleton pregnancies at term (between 37 and 42 weeks) at the Hospital Universitario San Cecilio between 2009 and 2010 both inclusive. Cases group: 98 at term NB with a birth weight < 2500 g; and an estimated fetal weight (EFW) by ultrasound in the 3rd trimester. Controls Group: 100 NB during the same period of time with birth weight between 3000-4000g, with EFW by ultrasound in the 3rd trimester randomly extracted. Results: The detection rate of small for gestational age infants born was 56.5% with 2% of incidence and the detection rate of intrauterine growth restriction type I was 11.1% with 0.1% of incidence within the total number of newborns in the period from 2009 to 2010. Conclusion: In our experience, EPF ultrasound in fetuses with weight below the 10th percentile has an error of 6% compared to birth weight, this allows proper identification of fetuses with SGA and IUGR.

Introducción y objetivo: Los estándares poblacionales de crecimiento intrauterino son necesarios para evaluar si el recién nacido (RN) ha crecido bien, si su estado nutricional es adecuado y para identificar grupos de riesgo como los pequeños para su edad gestacional (PEG). Se analizan las diferencias entre las curvas de crecimiento intrauterino utilizadas habitualmente en nuestro medio y el número de RN que cada una de ellas identifica como PEG. Material y métodos: Estudio transversal en 4.486 RN caucásicos (2.361 niños y 2.125 niñas), con una edad gestacional entre 35 y 41 semanas. La valoración antropométrica del RN (peso y longitud) se realizó siguiendo la metodología estándar. Se comparó el porcentaje de RN que quedaba con un peso y una longitud por debajo del percentil 10 (P10) para su edad gestacional a partir de cuatro curvas de crecimiento intrauterino (Olsen et al. 2010, Lubchenco et al. 1966, Delgado et al. 1996, Carrascosa et al. 2008), siendo diagnosticado de PEG. Resultados: El peso y longitud de los niños eran significativamente mayores que los de las niñas en todas las edades estudiadas. Los valores para el P10 en cada edad gestacional son globalmente similares entre las curvas analizadas y superponibles a los de nuestra población, con la clara excepción de la gráfica de Lubchenco et al. cuyos valores para el P10 son de hasta 300 g. menos en los RN de mayor edad gestacional. Las gráficas de Lubchenco et al. identifican un menor número de PEG que las otras. El porcentaje de niños PEG de nuestra muestra osciló entre un 1,7% y 14% en dependencia del estándar, sexo y edad gestacional considerados. Conclusión: El número de niños clasificados como PEG varía según el estándar utilizado. Las gráficas de Lubchenco, pese a su amplio uso, se alejan del patrón de crecimiento de nuestra población e identifican un menor número de PEG. El resto de curvas son similares entre ellas y parecen adecuadas para nuestro medio. La correcta identificación de los PEG permitirá valorar con mejor criterio los riesgos a corto y largo plazo de estos RN.Introduction and objective: Population standards of intrauterine growth are necessary to evaluate if the newborn has grown well, if their nutritional conditions are appropriate and to identify groups at risk as those small for gestational age (SGA). Differences in the number of SGA newborns identified, depending on the standard applied, have been analyzed in this study. Material and methods: Cross-sectional study conducted in 4,486 Caucasian newborns (2,361 boys and 2,125 girls), born between 35 and 41 weeks. Weight and length valuation was performed following the standard methodology. Percentage of children under the 10th percentile for weight and length was calculated depending on the standard used (Olsen et al. 2010, Lubchenco et al. 1966, Delgado et al. 1996, Carrascosa et al. 2008), being diagnosed of SGA. Results: Weight and length were significantly higher in boys than in girls at all ages. 10th percentile values defined for every gestational age are globally similar among the different standards and our population, with the clear exception of Lubchenco curves whose 10th percentile values are even 300 g. lower for the newborns at the highest gestational ages. Lubchenco charts do not fit the pattern of intrauterine growth of our population and identify a smaller number of SGA. The percentage of SGA of our sample ranged between 1.7% and 14% in depending on the standard, sex and gestational age considered. Conclusion: The number of children classified as SGA is different according to each standard used. Lubchenco charts identify a smaller number of SGA than the others. The rest of curves show similar values and seem to be well adapted for our population. The correct identification of SGA will allow a better assessment of short and long-term risks of these newborns.

Objetivo: dar a conocer a los participantes en el cuidado de la salud de la mujer embarazada, los más recientes avances y recomendaciones clínicas de un tema controversial que es causa importante de morbimortalidad perinatal en Colombia. Metodología: se revisaron las bases de datos Cochrane, Medline y Embase, además de la base latinoamericana SciELO, libros de la especialidad y consensos de otras sociedades científicas en búsqueda de estudios diagnósticos, revisiones sistemáticas, estudios aleatorizados y metaanálisis relativos a los términos: “restricción de crecimiento intrauterino” y “pequeño para la edad gestacional” en el período comprendido entre 1995-2009. A partir de esto, se realizó un manuscrito inicial, el cual fue sometido a discusión por medio de Internet. Posteriormente, el manuscrito final fue discutido y modificado en la ciudad de Medellín (Colombia), en el marco del congreso de Medicina Fetal S.A. en septiembre de 2008. Resultados: teniendo en cuenta la evidencia disponible, se presentó una guía para el manejo del feto PEG y con RCIU, la cual puede ser aplicada a Colombia. Conclusiones: estetemageneracontroversiadebido a la falta de evidencia científica para la aplicación de algunas definiciones y pruebas diagnósticas en su manejo.Objective: making those participating in pregnant women’s health care aware of the latest clinical recommendations regarding a controversial topic which is an important cause of perinatal morbidity in Colombia. Methodology: the Cochrane Library, Medline and Embase databases were searched as well as SciELO Latin-American database, specialised books and consensus from other scientific societies for diagnostic studies, systematic reviews, randomised trials and meta-analysis carried out between 19952009 regarding the terms “intrauterine growth restriction”and “small for gestational age”. An initial manuscript was written and submitted for on-line discussion. The final manuscript was discussed and amended in Medellín, Colombia, during the Foetal Medicine Congress held in September 2008. Results: a guide to managing SGA and IUGR foetuses was written and is presented here; it has been based on the best available evidence and could be applied in Colombia. Conclusions: this issue produces controversy due to a lack of scientific evidence for applying some definitions and diagnostic tests when managing IUGR and SGA foetuses.

OBJETIVOS: 1) evaluar la severidad y la proporcionalidad de los PEG para diferentes grados de prematurez; 2) estimar el riesgo de mortalidad de los PEG según la severidad y proporcionalidad. MATERIAL Y MÉTODOS: Diseño observacional y analítico. Población: todos los recién nacidos de muy bajo peso (RNMPB) entre 25 y 36 semanas que mantiene el grupo NEOCOSUR (n = 1.518). Índices antropométricos: a) peso de nacimiento (PN) < percentil 3 y 10; b) severidad (FGR, razón del crecimiento fetal - razón entre el PN observado y la media del PN para cada edad gestacional): normal: FGR 0,90-1,10, leve: 0,80-0,89, moderado: 0,75-0,79 y severo < 0,75; c) proporcionalidad: estimada por el Coeficiente de Bimodalidad (disarmónico: > 0,55) y la transformación z del índice ponderal (Ponderal Index, PI = g/cm³ x 100). Restricción del crecimiento intrauterino (RCIU) asimétrico: score z < -1. Mortalidad neonatal hasta el alta. RESULTADOS: PN < perc. 3: 13,5%; < perc. 10: 30,7%; FGR: 0,90±0,21; FGR leve 20,8%, moderado 8,7% y severo 32,6%. Coef. Bimodalidad: 0,53; índice ponderal: 2,27±0,51. Score z: 0,007±1,0; score z OBJECTIVES: To evaluate the clinical severity and proportionality of small for gestational age, very low birth weight neonates (< 1,500 g) and to estimate the neonatal mortality risk associated with the condition of being small for gestational age according to the degree of severity and proportionality. METHODS: Observational design. All of the NEOCOSUR Collaborative Group's very low birth weight infants (25-36 weeks' gestation) were included (n = 1,518). Anthropometric indices: birth weight < 3rd and 10th percentile. Severity (fetal growth ratio = observed weight/mean birth weight for gestational age); no growth restriction: fetal growth ratio 0.90-1.10, mild: fetal growth ratio 0.80-0.89, moderate: fetal growth ratio 0.75-0.79 and severe: fetal growth ratio < 0.75. Proportionality: coefficient of bimodality and z score for ponderal index (PI = g/cm³ *100). Neonatal mortality until discharge. RESULTS: < 3rd percentile: 13.5% (p < 0.001); < 10th percentile: 31% (p < 0.001); fetal growth ratio: 0.90±0.21 (p < 0.001), mild restriction: 20.8%, moderate restriction: 8.7% and severe restriction: 32.6%. Coefficient of bimodality: 0.53; PI z score < -1: 8%. Maternal hypertensive disease was systematically associated with being small for gestational age (aOR 1.20, 95% CI 0.86-1.67), fetal growth ratio < 0.89 (aOR 1.71, 1.24-2.36) and PI z score < -1 (aOR 1.60, 1.03-2.41). Adjusted odds ratios for neonatal mortality were: 2.64 (95% CI 1.71-3.92) for being small for gestational age, 2.76 (95% CI 1.85-4.10) for fetal growth ratio < 0.89, and 1.37 (95% CI 0.80-2.32) for z score PI < -1. CONCLUSIONS: Small for gestational age, mostly symmetric and severe restriction is a frequent condition in < 1,500 g neonates and is associated with higher mortality rates.

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Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. Presents diagnostic difficulties and benefits should be balanced with the increase of interventions. Objective: To determine the sensitivity of clinical - ultrasound diagnosis of Small for Gestational Age Infants (SGA). To assess the impact of prenatal diagnosis in cesarean section rate and neonatal outcome. Material and Methods: Retrospective descriptive and analytical trial, of the Latin American Center of Perinatology database Perinatal Information System (SIP). From March through September 2010 of a total of 4548 newborn child at the Centra Hospitalario Pereira Rossell, 379 were SGA Infants (defined as growth below p10 for gestational age). Of the target population, it was studied whether they had prenatal clinic and ultrasonographic diagnosis, number of prenatal visits, route of delivery and neonatal outcome (Apgar score, blood gases). Results: Of the 379 SGA cases, 99 (26%) had previous diagnosis of IUGR. The average gestational age for the diagnosis was 35 weeks. Of these 99 diagnosed cases, 88 (89%) had more than 5 prenatal visits compared to the group without previous diagnosis. 190 SGA (68%) had well controlled pregnancies. There was no difference in the neonatal outcome of depression, acidosis and low Apgar between the group with IUGR or without diagnosis. Cesarean sections were 56% in the group with previous diagnosis versus 21% in the group without diagnosis. The population group with prenatal diagnosis had 2,64 RR of cesarean section (95% Cl 1,98 - 3,51) p<0,0001. Conclusion: Because of the high percentage of pregnancies uncontrolled or poorly obstetric care can not conclude on the clinical sensitivity and / or prenatal ultrasound diagnosis of IUGR, and its impact on neonatal outcomes. The diagnosis of IUGR increases obstetric interventions and maternal morbidity due to the high rate of cesarean sections. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to determine the perinatal and socio-cultural characteristics of small gestational age (SGA) infants during their first six months of life. It states that the study evaluates diet and anthropometry during six months in a sample of 1596 newborns in Aragon, Spain. Results show that infants born SGA stayed smaller during the first six months of life. It is inferred that infants born SGA have converged nmany characteristics that lead to health risks.

Objective To examine the determinants of low birthweight (LBW), small-for-gestation (SGA) and preterm births in Lombok, Indonesia, an area of high infant mortality. Methods Data from The Supplementation with Multiple Micronutrient Intervention Trial (SUMMIT), a double-blind cluster-randomised controlled trial, were analysed. The odds ratio of factors known to be associated with LBW, SGA and preterm birth was assessed and adjusted for the cluster design of the trial using hierarchical logistic regression. Determinants included constitutional, demographic and psychosocial factors, toxic exposure, maternal nutrition and obstetric history and maternal morbidity during and prior to pregnancy. Population attributable risks of modifiable determinants were calculated. Results A cohort of 14 040 singleton births was available for analysis of LBW, with 13 498 observations for preterm births and 13 461 for SGA births. Determinants of LBW and SGA were similar and included infant's sex, woman's education, season at birth, mothers' residence, household wealth, maternal mid-upper arm circumference (MUAC), height and a composite variable of birth order and pregnancy interval. Socioeconomic indicators were also related to preterm births and included mother's education, residence and household wealth, while nutritional-related factors including low MUAC and birth order and interval were associated with preterm birth but not maternal height. Nausea was protective of preterm birth, while diarrhoea was associated with higher odds of preterm birth. Oedema during pregnancy was protective of SGA but associated with higher odds of preterm delivery. Around 33%, 13% and 13% of the determinants of LBW, SGA and preterm births were preventable. Conclusion Women's education, maternal nutrition and household wealth and family planning are key factors to improving birth outcomes. [ABSTRACT FROM AUTHOR]

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Introduction and objective: Population standards of intrauterine growth are necessary to evaluate if the newborn has grown well, if their nutritional conditions are appropriate and to identify groups at risk as those small for gestational age (SGA). Differences in the number of SGA newborns identified, depending on the standard applied, have been analyzed in this study. Material and methods: Cross-sectional study conducted in 4,486 Caucasian newborns (2361 boys and 2,125 girls), born between 35 and 41 weeks. Weight and length valuation was performed following the standard methodology. Percentage of children under the 10th percentile for weight and length was calculated depending on the standard used (Olsen et al. 2010, Lubchenco et al. 1966, Delgado et al. 1996, Carrascosa et al. 2008), being diagnosed of SGA. Results: Weight and length were significantly higher in boys than in girls at all ages. 10th percentile values defined for every gestational age are globally similar among the different standards and our population, with the clear exception of Lubchenco curves whose 10th percentile values are even 300 g. lower for the newborns at the highest gestational ages. Lubchenco charts do not fit the pattern of intrauterine growth of our population and identify a smaller number of SGA. The percentage of SGA of our sample ranged between 1.7% and 14% in depending on the standard, sex and gestational age considered. Conclusion: The number of children classified as SGA is different according to each standard used. Lubchenco charts identify a smaller number of SGA than the others. The rest of curves show similar values and seem to be well adapted for our population. The correct identification of SGA will allow a better assessment of short and long-term risks of these newborns. [ABSTRACT FROM AUTHOR]

Objective: making those participating in pregnant women's health care aware of the latest clinical recommendations regarding a controversial topic which is an important cause of perinatal morbidity in Colombia. Methodology: the Cochrane Library, Medline and Embase databases were searched as well as SciELO Latin-American database, specialised books and consensus from other scientific societies for diagnostic studies, systematic reviews, randomised trials and meta-analysis carried out between 1995- 2009 regarding the terms "intrauterine growth restriction" and "small for gestational age". An initial manuscript was written and submitted for on-line discussion. The final manuscript was discussed and amended in Medellín, Colombia, during the Foetal Medicine Congress held in September 2008. Results: a guide to managing SGA and IUGR foetuses was written and is presented here; it has been based on the best available evidence and could be applied in Colombia. Conclusions: this issue produces controversy due to a lack of scientific evidence for applying some definitions and diagnostic tests when managing IUGR and SGA foetuses. [ABSTRACT FROM AUTHOR]

The placental metabolism, the exchange of substances and the production of hormones are vital functions of the placenta to maintain and promote the normal development of the fetus. There are risk factors that disrupt this pattern in the case of intrauterine growth retardation, whose outcome will be a small for gestational age (SGA) newborn having a higher morbidity, physical and intellectual growth pledged and greater probability of develop different pathologies during adulthood. The aims of this study are: 1 .-recognize the morphometric parameters differences as the área of the villi, the área of the vessel, the number of vessels and the área of placental syncytiotrophoblast SGA in connection with placentas of newborns AGA and 2.- relate the diagnosis of neonatal SGA with morphometric characteristics. We used 25 placenta at term (37-42 weeks), 12 newborns appropriate to the gestational age (AEG), and 13 small for gestational age infants (SGA). The samples were obtained from the Maternity Hospital Hernán Henriquez Aravena of Temuco, Chile IX Región. In each placenta two segments were taken from the subchorionic píate to the basal píate and then were fixed in 10% formalin buffered. The histological techniques used were H- E Alcián blue, Masson's Trichromic, Pas-hematoxylin Pas-diastase. The área of the villi showed significant differences between the control group (AEG) and the PEG group with p = 0.0194. In the group of PEG the área of vessels was significantly higher, with a valué of 234.05 mm2 compared with the control group whose average was 150.99 mm2 (p = 0.0001). The number of blood vessels for free villi sampling not significant differences. Regarding the area of syncytiotrophoblast the difference was not significantly (p = 0.1410). In conclusión it was determined that PEG newborns placenta showed significant differences at the blood vessel área and free chorial villi área in relation to the AEG placenta. [ABSTRACT FROM AUTHOR]

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Introduction: Preterm newborns (PN) have a higher risk of thyroid dysfunction than term newborns (TN). This condition may go unnoticed in neonatal screening due to a late elevation of thyrotropin (TSH) in these patients., Objective: Evaluate thyroid function in the second week of life in PN of < 32 weeks gestation (WG), and to identify factors associated to its alteration., Patients and Methods: A retrospective study was performed in neonates of < 32 weeks gestation (WG), in whom thyroid function was determined. An analysis was performed on thyroxine (T4L) and TSH levels, as well as their association with perinatal and neonatal outcomes., Results: The study included a total of 358 patients with mean gestational age (GA) of 29.3 weeks, and mean birth weight (BW) 1127 grams. A linear correlation was found between T4L and BW (correlation coefficient (R) 0.356; p < 0.001) and GA (R = 0.442; p < 0.001). TSH values were associated with small for gestational age (SGA 5.3 mU/L [1.5-37]; non-SGA 2.89 mU/L [0.2-19.5]; p < 0.001), inotropic support (Yes 3.98 mU/L [0.6-22.9]; No 3.16 mU/L [0.2-37]; p = 0.019) and BW (R = -0.249; p < 0.001). Nine (2.5%) patients were treated with levothyroxine, of whom six were SGA., Conclusions: Thyroid function analysis in the second week of life helps to identify asymptomatic newborns with risk of thyroid dysfunction. SGA newborns are at higher risk of thyroid function alterations., (Copyright © 2022. Published by Elsevier España, S.L.U.)

Introduction: Several studies conclude that small for gestational age (SGA) children have a higher number of comorbidities, as well as a different hormonal profile compared to those with appropriate weight for gestational age (AGA). Thyroid hormones play an important role in growth and neurocognitive development. Thyroid function in SGA children is still not completely known., Objectives: To compare the thyroid function of SGA children during the first 2 years of life with that in publications on thyroid function in other groups of infants, such as AGA and premature children, using the same methodology., Methods: A cohort of 38 SGA children was obtained, in which the thyrotropin (TSH) values in blood were measured at different points in the development of the SGA child. The results were compared with a population of AGA children from Zaragoza and a population of premature children from Barcelona by comparing the means using a 2-tailed test., Results: A statistically significant difference (P < 0.05) was observed between the SGA children in our study and the AGA children older than 6 months, but not between the SGA children of the study and the population of premature infants., Conclusions: SGA children have higher TSH values compared to AGA children older than 6 months. Therefore, it seems reasonable to establish a screening and a follow-up protocol in those SGA with high risk to develop thyroid dysfunction., (Copyright © 2021 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

A wide variation in height gain rate is observed in children small for gestational age (SGA) treated with growth hormone (GH). The aim of this study was to evaluate prepubertal and pubertal growth, height gain attained at adult age and to assess potential predictive factors in catch-up growth. Changes in metabolic profile were also analyzed., Patients and Methods: Seventy-eight children born SGA were treated with a GH median dose of 33.0±2.8mcg/kg/day at a mean age of 7.3±2.0 (boys) and 6.0±1.8 (girls)., Results: Mean height (SDS) at GH onset was -3.31±0.7 for boys and -3.48±0.7 for girls. According to age at pubertal growth spurt onset patients were classified in their pubertal maturity group. Adult height attained expressed in SDS was -1.75±0.7 for boys and -1.69±1.0 for girls, both below the range of their mid-parental height. The greatest height gain occurred during the prepubertal period. Patients with greater height gain were lighter (p<0.001), shorter (p=0.005), and younger (p=0.02) at the start of GH, and also showed a greater increase in growth velocity during the first year on GH (p<0.001). SGA children started puberty at the same age and with the same distribution into pubertal maturity group as the reference population. No relevant GH-related adverse events were reported, including in the insulin resistance parameters evaluated. Differences were found in fasting plasma glucose values, but were without clinical relevance. IGF-I plasma values remained within the safety range., Conclusions: GH therapy is safe and beneficial for SGA children. The response to GH therapy is widely heterogeneous, suggesting that GH should be started at a young age and the GH dose prescribed should be individualized. SGA children started puberty at the same age as the reference population. The only factor that predicts greater adult height is growth velocity during the first year of therapy., (Copyright © 2021 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Preterm newborns (PN) have a higher risk of thyroid dysfunction than term newborns (TN). This condition may go unnoticed in neonatal screening due to a late elevation of thyrotropin (TSH) in these patients., Objective: Evaluate thyroid function in the second week of life in PN of < 32 weeks gestation (WG), and to identify factors associated to its alteration., Patients and Methods: A retrospective study was performed in neonates of < 32 weeks gestation (WG), in whom thyroid function was determined. An analysis was performed on thyroxine (T4L) and TSH levels, as well as their association with perinatal and neonatal outcomes., Results: The study included a total of 358 patients with mean gestational age (GA) of 29.3 weeks, and mean birth weight (BW) 1127 grams. A linear correlation was found between T4L and BW (correlation coefficient (R) 0.356; p < 0.001) and GA (R = 0.442; p < 0.001). TSH values were associated with small for gestational age (SGA 5.3 mU/L [1.5-37]; non-SGA 2.89 mU/L [0.2-19.5]; p < 0.001), inotropic support (Yes 3.98 mU/L [0.6-22.9]; No 3.16 mU/L [0.2-37]; p = 0.019) and BW (R = -0.249; p < 0.001). Nine (2.5%) patients were treated with levothyroxine, of whom six were SGA., Conclusions: Thyroid function analysis in the second week of life helps to identify asymptomatic newborns with risk of thyroid dysfunction. SGA newborns are at higher risk of thyroid function alterations., (Copyright © 2020. Publicado por Elsevier España, S.L.U.)

Introduction: Several studies conclude that small for gestational age (SGA) children have a higher number of comorbidities, as well as a different hormonal profile compared to those with appropriate weight for gestational age (AGA). Thyroid hormones play an important role in growth and neurocognitive development. Thyroid function in SGA children is still not completely known., Objectives: To compare the thyroid function of SGA children during the first 2 years of life with that in publications on thyroid function in other groups of infants, such as AGA and premature children, using the same methodology., Methods: A cohort of 38 SGA children was obtained, in which the TSH values in blood were measured at different points in the development of the SGA child. The results were compared with a population of AGA children from Zaragoza and a population of premature children from Barcelona by comparing the means using a 2-tailed test., Results: A statistically significant difference (P<.05) was observed between the SGA children in our study and the AGA children older than 6 months, but not between the SGA children of the study and the population of premature infants., Conclusions: SGA children have higher TSH values compared to AGA children older than 6 months. Therefore, it seems reasonable to establish a screening and a follow-up protocol in those SGA with high risk to develop thyroid dysfunction., (Copyright © 2020. Publicado por Elsevier España, S.L.U.)

Objective: To assess the impact of glycemic control in gestational on neonatal weight and metabolic complications of twin and singleton pregnancies., Methods: An observational, retrospective study to monitor 120 twin and 240 singleton pregnancies in women with GDM. Maternal glycemic parameters during pregnancy (oral glucose tolerance test results, treatment, insulinization rate, mean HbA1c in the third trimester), and neonatal complications and weight were recorded., Results: A higher infant birth weight ratio (IBWR 1.02±0.12 vs. 0.88±0.12, P<.001) and a lower rate of newborns small for gestational age (severe SGA 2.5% vs. 8.3%, P=.012) were seen after singleton pregnancies as compared to twin pregnancies. The rates of newborns large for gestational age (LGA 12.6% vs. 12.5%, P=.989); macrosomic (6.7% vs. 7.5%, P=.777); or small for gestational age (SGA 6.7% vs. 10.8%, P=.175) were similar in both groups. Neonates from twin pregnancies had a higher risk of hypoglycemia (adjusted OR 4.71; 1.38-16.07, P=.013) and polycythemia (adjusted OR 10.05; 1.82-55.42, P=0.008). A linear relationship was seen between third trimester HbA1c levels and IBWR in singleton (r=.199, P=.003), but not in twin pregnancies (r=0.049, P=0.610)., Conclusions: Risk of severe SGA, hypoglycemia, and polycythemia was significantly higher in twin pregnancies of women with GDM. Neonatal weight outcomes and metabolic complications in twin pregnancies of women with GDM were not related to glycemic control. Moreover, in our study population, fasting glucose at diagnosis and mean HbA1c in the third trimester showed a linear relationship with higher birth weights in singleton, but not in twin pregnancies., (Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)