ESPE Abstracts (2016) 86 RFC6.8

The Actual Incidence of Small for Gestational Age (SGA) Newborns and their Catch-up Growth is Dramatically Lower than Previously Considered

Eran Lavia, Asher Shafrira, Abdulsalam Abu Libdeha, Chen Stein-Zamirc, Smadar Eventov Friedmanb, Hanna shoobc & David Haim Zangena

aDivision of Pediatric Endocrinology, Hadassah, Hebrew University Medical Center, Jerusalem, Israel; bDepartment of Neonatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; cJerusalem District Health Office, Ministry of Health, The Hebrew University, Hadassah, Jerusalem, Israel

Background: SGA is defined as birth weight under 2 standard deviations (SD) from the mean. Previous studies indicate that 10% of SGA babies do not have “catch-up growth” (CUG). They are eligible for growth hormone (GH) therapy to increase final height. The unexpected low demand for GH therapy in SGA babies, triggered us to survey the actual incidence of SGA and failure in CUG.

Objective and hypotheses: To find the actual incidence of SGA and failure in CUG in SGA children.

Method: Our cohort included all-43,307 babies born at Hadassah hospitals in Jerusalem between 2008–2011. SGA was defined according to WHO parameters and the corresponding Israeli criteria (weight<2SD, Dolberg’s table 2005). Our calculated birth weight percentiles were compared to the nationally used percentile data (NUPD). Follow-up measurements of height and weight were obtained from the pediatrician or from the municipal pediatric growth follow-up centers.

Results: Only 524 babies in the cohort (1.2%) were SGA (52% of expected). This finding was consistent annually. Birth weight percentile comparisons showed that 1st and 5th percentile weights in our cohort were significantly (20%) higher while the 95th and 99th percentiles were 5% lower than the NUPD. CUG parameters (currently available for 377/524 SGA) indicated that 356 (95.4%) had CUG in the first 2 years (height >2.5SD below the mean).CUG rate among term SGA infants was even higher-96.7%.

Conclusion: This large cohort representing a heterogeneous (socioeconomic status and multiethnic) western Caucasian population indicates that the actual number of SGA newborns is nearly half of the expected according to WHO/NUPD definitions. The incidence of infantile CUG is also significantly higher than previously reported. As these findings may have an impact on morbidity, health cost planning and GH requirements in SGA babies, expanding this study to both Europe and the US is warranted.

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