Definition of "SGA"

Last modified: 10 months



Small for gestational age (SGA) are babies who are smaller in size than normal for gestational age.

Dx
  • Fundal height, less than it should be for that stage of pregnancy, per McDonald's rule
  • U/S, to confirm AC or EFW<10% percentile for gestational age

Source: WA Health

Patient information

What is SGA?
It's where bub's weight is below the 10th percentile for gestational age.

OK. But if bub is in mom's tummy, how do you weigh them?
We can measure fundal height, by feeling mom's tummy for the size of the womb. Or an ultrasound.

Causes
  • Constitutionall small, as a genetic trait
  • IUGR (intrauterine growth restriction)

Patient information

What causes bub to be below the 10th percentile of weight?
So they can just be small because mom and dad is small, and they're going to be small. Or there can be some problem that's causing it.

Ix
  • U/S (serial growth scans), to monitor growth

Patient information

How do you check for bub below 10th percentile for weight?
Repetitive ultrasounds, where we track growth, and can plot it on a chart to monitor it.

Tx
  • For hypoglycemia:
    • Frequent feedings
    • Addition of cornstarch-based products (e.g. Duocal powder) to the feedings
  • Refer to:
    • Endocrinologist, if Pt's do not catch up to growth by 2yo. GH (growth hormone) therapy is sometimes required
    • Gastroenterologist, to address reflux/GERD, delayed gastric emptying/DGE
    • Dietician, to address calorie deficit and FTT
    • Speech pathologist or OT, to address feeding issues, or sensory issues
    • Behaviorist, for feeding issues, usually for kids >2yo
    • Allergist, to Dx/rule out any food allergies, although this isn't necessarily more common in SGA
    • ENT, to Dx enlarged adenoids or tonsils, although this isn't necessarily more common in SGA
Prognosis
  • 90% of babies born SGA catch up by 2yo
Complications
  • FTT (failure ot thrive)
  • Hypoglycemia → common in asymmetrical SGA because their larger brains burn calories at a faster rate than their usually limited fat stores hold
See also
  • Low birth weight (<2.5kg, regardless of gestational age at time of birth)
  • IUGR (fundal height less than it should be for that stage of pregnancy)
  • LGA (antonym, large for gestational age)

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