ESPE Abstracts

Introduction: Children born small for gestational age (SGA) are extensively studied since the 60s of the last century. Short-term and long term sequels of the condition lead to the concept of necessary follow up throughout childhood and early adulthood. Based on the current knowledge, SGA births are between 5% and 7% of all, with about 10% failing to catch-up up to 2 years of age. The timely capture of such individuals within general practices and even within pediatric practices is still poor. Interventions specially designed to increase awareness among doctors, parents and society, are expected to improve outcomes in such children.

Aim: To assess the first 6 months results of the pilot Programme for early detection and follow-up of SGA children.

Patients and Methods: Being born SGA is generally defined as birth weight and/or length less than the 3rd percentile (-1.88 SD). In 2013 Fenton et al. developed new growth charts combining both pre-term and full term babies born SGA. They suggested that the definition should be updated to babies born less than the 10th percentile (-1.28 SD). In 2021 the pilot Programme for early detection and follow-up of SGA children has been established (www.mgv.growinform.org). A total of 23 neonatology clinics enrolled for participation. There are two coordinators supporting maternities monthly, and 2 education sessions were conducted so far. The study was approved by the University Ethical committee, and written informed consent (IC) was collected from both parents. Participating children will be evaluated at the age of 2 by the geographically nearest pediatric endocrinologist (PE), with 24 participating PE.

Results: For the first six months of the project 275 newborns were identified as SGA, assuming 3.7% SGA births. From those, 139 (50.5%) signed IC. The distribution within the country seemed to be unequal. The only participating University tertiary referrals neonatal clinic registered 6% SGA children. Two big maternities in large cities managed to identify between 8% and 9% SGA births, but only one of them succeeded in acquiring consent from 87.5% of the patients’ families. However, most of the neonatal clinics registered only between 1 and 3.4% SGA births. Evaluation of the implementation is currently underway.

Conclusion: The first results of the pilot Programme are failing to support the validity of the chosen approach. Potential pitfalls such as using old SGA definitions, lack of staff and motivation, etc., are currently being evaluated in order to modify the Programme accordingly.