Small for Gestational Age (SGA)

DEFINITION

If a newborn is smaller than the age of the pregnancy, then the baby is said to Small for gestational age (SGA).

CAUSE

There are several conditions that can cause babies born small for gestational age, namely:

-Heredity or genetics, for example, parents are small or there is a hereditary disease that is associated with a small body stature

-The function of the placenta (cord) are interrupted, for example in:

·         women with high blood pressure (hypertension)

·         women who experience preeclampsia

·         women with kidney disease

·         mothers with chronic diabetes

-Viral infections, such as cytomegalovirus, German measles, or Toxoplasma, which is obtained before the baby is born

-Impaired fetal growth due to mothers who smoke or use alcohol / drugs while pregnant

SYMPTOMS

In contrast to premature infants, SGA infants who are old enough to have had a perfect organ. Most of SGA infants have no symptoms, unless they were infected with the virus or have certain genetic syndromes. In addition to his size, infants were small for gestational age have physical and behavioral characteristics (eg spontaneous activity and appetite) similar to babies who are born with normal size appropriate gestational age.

If prior to delivery in placental function has been impaired, the reduced blood flow during childbirth can jeopardize the delivery of oxygen and causing injury to the fetus.

Babies who are small for gestational age at risk for experiencing:

·         Meconium aspiration. Babies during labor deprived of oxygen will issue its first stool (meconium) into the amniotic fluid. If the baby inhale amniotic fluid containing meconium, the meconium can clog the airway and hampering breathing. The inhaled meconium can also cause inflammation of the lungs.

·         The number of red blood cells were excessive, it could happen if the SGA infants experiencing mild chronic oxygen deficiency due to inadequate supply of the placenta.

·         Low blood sugar levels, often occurs in a few hours and the first few days due to a lack of glycogen reserves in the baby's body.

·         Difficulty to regulate body temperature

·         Disorders of the immune system

During the womb, infants stunted growth due to poor nutritional intake, but soon after birth, if the baby is getting adequate nutrients, then the growth will be rapid. However, some babies are small for gestational age (SGA) will remain small when childhood and adulthood, depending on the cause and severity of growth retardation occurring.

DIAGNOSIS

Diagnosis is based on symptoms exist and physical examination, in which the baby's weight is less than the average weight loss of 90% of babies born with the same gestational age.

TREATMENT

There is no specific treatment for infants small for gestational age, treatment is done to address the underlying conditions and complications exist.

PREVENTION

It is important to perform regular checks during pregnancy. In addition, pregnant women should avoid the use of alcohol or drugs, and cigarettes.

REFERENCE

- K, Arthur E. Small for Gestational Age. Merck Manual Home Health Handbook. 2009.

- K, James W. Small for Gestational Age. The Merck Manual. 2012.

- V, Linda J. Small for Gestational Age. Medline Plus. 2011.