Erschienen in:
27.05.2019 | Editorial Commentary
Small for Gestation Age Neonates: Unmet Clinical Care and Research Need
verfasst von:
Deepak Chawla
Erschienen in:
Indian Journal of Pediatrics
|
Ausgabe 7/2019
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Excerpt
Small-for-gestation age (SGA) neonates, those born at less than 10th percentile of the birthweight-for-gestational age, gender-specific reference population, have been recognized to be at higher risk of death and various neonatal and adult-onset morbidities. Prevalence of SGA neonates among live births increases with increasing proportion of low birthweight (LBW) neonates in a population. According to an estimate, 26% neonates born in South Asia are LBW and 44.5% are SGA, both figures being highest for any region in the world, including Africa [
1]. With largest number of SGA births every year, this category is a major contributor to not only neonatal mortality and morbidity, but also adult-onset metabolic disorders like diabetes in India. Despite this, SGA is rarely the focus of research publications emanating from this part of the world. The study by Mallick and colleagues in this issue of journal reports increased risk of major neonatal morbidities in SGA late preterm neonates [
2]. Despite the SGA population having a relatively ‘good’ mean birth weight of 1.91 kg, about 90% had at least one of the pre-defined neonatal morbidities. Hypoglycemia, hypothermia and proven sepsis were observed in about one-third of neonates, respiratory support was needed in more than 40% neonates and feeding difficulty was observed in about 80% neonates. In comparison to appropriate for gestation age late preterm neonates, risk of most of the morbidities was more than double (relative risk >2). Combined with high burden, this high rate of illness highlights the resources needed to care for this population. No wonder, most of special newborn care units (SNCUs) are crowded, mostly with SGA neonates. …