Small for Gestational Age
Definition
A baby who is small for gestational age (SGA) has a significantly lower weight than other babies of the same gestational age. Gestational age is the number of weeks into pregnancy.

Newborn

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Causes
If parents have small stature, the baby may be small. These babies have normal development but are just small compared to others their age.

SGA sometimes occurs if there are growth and development problems before birth. These may occur with:

  • Problems with the supply of nutrients and oxygen to the baby or a small uterus—can cause a condition known as intrauterine growth restriction (IUGR)
  • Birth defects
  • Genetic syndromes
Risk Factors
Parents with small stature increase the risk of SGA.

Maternal factors that can affect a baby’s growth during pregnancy include:

Other factors that can affect baby’s growth include:

Symptoms
Symptoms of SGA include a birth weight that is in the lowest 10% of babies with same gestational age.

Diagnosis
Your baby’s doctor will do a physical exam. A baby with SGA is often diagnosed before birth based on measurements taken of the mother’s abdomen, the mother’s weight, and ultrasound results. If the measurement is low for the number of weeks of pregnancy, then the baby may be smaller than average. SGA may also be diagnosed at birth based on the baby’s weight and height.

Images may be taken during pregnancy with an ultrasound.

Treatment
Talk with your doctor about the best treatment plan for you. A baby with SGA is at higher risk for problems, such as difficulty feeding, blood sugar abnormalities, and breathing problems. The doctor will want to monitor your baby’s health and development closely.

Babies that have SGA due to lack of nutrition or oxygen may need treatment. Options include:

Before Delivery
Before your baby is born, the doctor may:

  • Monitor your baby’s growth progress closely
  • Deliver your baby early if the uterus is too small to allow your child to develop or there are problems with the mother’s health or the placenta that are affecting the babies growth
  • Deliver your baby later if your baby is growing well, but is not ready to be born due to gestational age
After Delivery
Babies who are born with SGA may be weak and unable to feed properly or stay warm. Treatment may include:

  • Using warming beds or incubators
  • Providing tube feedings
  • Monitoring oxygen levels
Prevention
SGA due to family traits cannot be prevented.

To help reduce your baby’s chance of getting SGA due to nutrition and oxygen problems during birth, take these steps during pregnancy:

  • If you smoke, quit.
  • If you use drugs or alcohol, ask your doctor to refer you to a treatment program that will help you stop.
  • Start prenatal care early and continue throughout pregnancy.



RESOURCES:
American Academy of Pediatrics

American Pregnancy Association

CANADIAN RESOURCES:
Canadian Paediatric Society


References:
Intrauterine growth restriction (IUGR). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 25, 2013. Accessed October 24, 2013.

Intrauterine growth restriction (IUGR); Small for gestational age (SGA). American Pregnancy Association website. Available at: http://americanpregnancy.org/pregnancycomplications/iugr.htm. Updated January 2007. Accessed October 24, 2013.

Small for gestational age. Lucile Packard Children’s Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrnewborn/sga.html. Accessed October 24, 2013.

Small for gestational age babies. Patient UK website. Available at: http://www.patient.co.uk/doctor/small-for-gestational-age-babies. Updated May 28, 2013. Accessed October 24, 2013.

Small for gestational age introduction. The MAGIC Foundation website. Available at: http://www.magicfoundation.org/www/docs/111. Accessed October 24, 2013.

11/19/2013 DynaMed’s Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Roos N, Neovius M, et al. Perinatal outcomes after bariatric surgery: nationwide population based matched cohort study. BMJ 2013;347:f6460.

Last Reviewed November 2013



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