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Jeong, Hwal Rim, Jae-A. Han, Heeji Kim, Hye Jin Lee, Young Suk Shim, Min Jae Kang, Jong Seo Yoon, Seongho Ryu, and Il Tae Hwang. "Exosomal miRNA Profile in Small-for-Gestational-Age Children: A Potential Biomarker for Catch-Up Growth." Genes 13, no. 6 (May 24, 2022): 938. http://dx.doi.org/10.3390/genes13060938.
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Objective: The mechanism underlying postnatal growth failure and catch-up growth in small-for-gestational-age (SGA) children is poorly understood. This study investigated the exosomal miRNA signature associated with catch-up growth in SGA children. Methods: In total, 16 SGA and 10 appropriate-for-gestational-age (AGA) children were included. Serum exosomal miRNA was analyzed using next-generation sequencing (NGS). Exosomal miRNA was profiled for five SGA children with catch-up growth (SGA-CU), six SGA children without CU growth (SGA-nCU), and five AGA children. Results: Exosomal miRNA profiles were clustered into three clear groups. The exosomal miRNA expression profiles of the SGA-nCU group differed from those of the SGA-CU and AGA groups. In all, 22 miRNAs were differentially expressed between SGA-nCU and AGA, 19 between SGA-nCU and SGA-CU, and only 6 between SGA-CU and AGA. In both SGA-nCU and SGA-CU, miR-874-3p was upregulated and miR-6126 was downregulated. Therefore, these two miRNAs could serve as biomarkers for SGA. Compared with SGA-CU and AGA, miR-30c-5p, miR-363-3p, miR-29a-3p, and miR-29c-3p were upregulated in SGA-nCU, while miR-629-5p and miR-23a-5p were downregulated. These six miRNAs could be associated with growth failure in SGA-nCU children. Conclusions: SGA children without CU have a distinct exosomal miRNA expression profile compared with AGA and SGA children with CU. Exosomal miRNAs could serve as novel biomarkers for CU.
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YILDIZ, Duran, Ufuk ÇAKIR, Ali Ulaş TUĞCU, and Cüneyt TAYMAN. "Relationship between thyroid function tests and small for gestational age in preterm newborns." Cukurova Medical Journal 47, no. 4 (December 28, 2022): 1656–62. http://dx.doi.org/10.17826/cumj.1171931.
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Purpose: The aim of this study was to evaluate the relationship between thyroid hormone levels and clinical outcomes in preterm, small for gestational age (SGA) infants.
Materials and Methods: The premature newborns (gestational age of ≤30 weeks) were divided into two groups as SGA and non-SGA. Thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels, the frequency of congenital hypothyroidism (CH), demographic and clinical characteristics, morbidity and mortality rate were compared between the groups.
Results: A total of 430 premature newborns, 72 in the SGA group and 358 in the non-SGA group were included. The frequency of CH, morbidity, demographic and clinical characteristics were similar between two groups. The mortality rate was higher in SGA (36.1%) than in non-SGA group (13.6%). Serum fT4 level was lower in SGA group (1.04±0.30 ng/dl) compared to the non-SGA group (1.24±0.33 ng/dl). The serum TSH level was higher in SGA group (9.91 ± 5.6 uIU/L) than in non-SGA group (6.6 ± 5.2 uIU/L).
Conclusion: The frequency of thyroid dysfunction was higher in preterm SGA infants compared to non-SGA, which was due to transiently high TSH and low fT4 concentrations. Therefore, thyroid function tests should be monitored periodically in preterm and SGA infants.
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Pilliod, Rachel A., Amy E. Doss, Jonathan M. Snowden, Yvonne W. Cheng, Jessica M. Page, Brian Shaffer, and Aaron B. Caughey. "147: SGA cohort." American Journal of Obstetrics and Gynecology 206, no. 1 (January 2012): S77. http://dx.doi.org/10.1016/j.ajog.2011.10.165.
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Mohn, Angelika, Valentina Chiavaroli, Marina Cerruto, Annalisa Blasetti, Cosimo Giannini, Tonino Bucciarelli, and Francesco Chiarelli. "Increased Oxidative Stress in Prepubertal Children Born Small for Gestational Age." Journal of Clinical Endocrinology & Metabolism 92, no. 4 (April 1, 2007): 1372–78. http://dx.doi.org/10.1210/jc.2006-1344.
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Abstract Context: Low birth weight is associated with an increased risk of metabolic and cardiovascular diseases in adulthood. The development of insulin resistance (IR) seems to play a pivotal role; no data on the oxidant-antioxidant status are available in this risk group. Objective: This study is an assessment of oxidant-antioxidant status in prepubertal children born small for gestational age (SGA) in comparison to healthy controls and the relationship to IR. Design: This cross-sectional study compares indexes of IR and oxidant-antioxidant status in three different groups (SGA+, SGA−, controls), with analysis by post hoc and Pearson correlation. Setting: The study was conducted in the Academic Department of Pediatrics. Participants: A total of 19 SGA+ and 16 SGA− children were compared with 13 controls. Intervention: No intervention was used. Main Outcome Measures: Indexes of IR (glucose to insulin ratio, homeostasis model assessment of IR) were evaluated, and markers of oxidative stress (lag phase, malonildialdehyde, vitamin E) were measured. Results: Homeostasis model assessment of IR was significantly higher in SGA+ than SGA− children (1.32 ± 0.9 vs. 0.69 ± 0.47; P = 0.03) and controls (0.71 ± 0.37; P = 0.04). Glucose to insulin ratio was significantly lower in SGA+ than SGA− children (12.41 ± 5.01 vs. 26.54 ± 17.18; P = 0.02) and controls (26.96 ± 20.70; P = 0.04). Lag phase was significantly shorter in SGA+ than SGA− children (24.3 ± 4.38 vs. 35.59 ± 11.29 min; P = 0.003) and controls (45.28 ± 7.69 min; P = 0.0001) and in SGA− than controls (P = 0.01). Malonildialdehyde was significantly higher in SGA+ than SGA− children (0.79 ± 0.3 vs. 0.6 ± 0.1 nmol/mg; P = 0.03) and controls (0.36 ± 0.04 nmol/mg; P = 0.0001) and in SGA− children than controls (P = 0.02). Vitamin E was significantly reduced in SGA+ children than controls (27.54 ± 7.9 vs. 43.23 ± 11.32 μmol/liter; P = 0.002). Conclusion: Oxidative stress is present in both SGA+ and SGA− children, with a continuous alteration in relation to IR. Therefore, catch-up growth might exert the greatest influence in the development of future diseases.
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Machado, Quésia do Nascimento, and Gleison Guardia. "SGA - Sistema de gerenciamento de auxílio/ SGA - aid management system." Brazilian Journal of Development 7, no. 4 (April 26, 2021): 41875–89. http://dx.doi.org/10.34117/bjdv7n4-582.
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Austin, Claire M., Michael Dias, Jane E. Norman, Corinne Love, Rachael Wood, and Sarah J. Stock. "An evaluation of the potential to improve perinatal outcomes by improving antenatal detection of small for gestational age babies in Scotland: a retrospective population cohort study." Wellcome Open Research 5 (February 19, 2020): 35. http://dx.doi.org/10.12688/wellcomeopenres.15532.1.
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Background: Small for gestational age (SGA) babies are at high risk of perinatal mortality. We aimed to determine the potential to reduce perinatal mortality by improving antenatal detection of SGA babies in Scotland. Methods: We conducted a retrospective population study of all singleton SGA babies born in the 15 Consultant-led maternity units in Scotland in a 3-month period (1st Dec 2014 to 28th Feb 2015 inclusive). Demographic and pregnancy outcome data were extracted from Scottish birth records for all pregnancies; case note review was performed for all SGA cases [defined as birthweight less than the 10th centile for their gestational age at delivery as defined by the appropriate sex-specific UK-WHO Child Growth Standards]. Results: The SGA rate in Scotland was 5.5% (673/12218; 95% confidence interval [CI] 5.1, 5.9) and 27.6% (186/673; 95% CI 24.3, 31.2) of SGA cases were identified prior to delivery. SGA was associated with 18.2% (12/66; 95% CI [10.1%, 30.0%) of all perinatal deaths. The majority (10/12, 83.3%) of SGA babies who died had been identified as SGA in the antenatal period. There was no difference in perinatal mortality whether SGA was detected or not (5.4% [10/186; 95% CI 2.8, 10.0] in the SGA detected group vs 0.4% [2/487 [95% CI 0.3, 2.2] in the non-detected group after adjusting for risk factors for SGA, gestation at delivery and birthweight centile (Adjusted odds ratio [AOR] 0.85 [95% CI 0.5, 1.5], p=0.556). Conclusions: Despite only around a quarter of SGA babies being identified antenatally, the potential to reduce perinatal mortality in the Scottish population by improving SGA detection is limited. Only a minority of perinatal deaths occurred in SGA babies; and in the majority of these SGA was detected antenatally.
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S., Alph Shirley, Antony Leo Jerry T., and Shiji R. "Incidence and risk factors associated with hypoglycemia in the first 48 hours of life in Small for Gestational Age Neonates." International Journal of Contemporary Pediatrics 5, no. 6 (October 22, 2018): 2300. http://dx.doi.org/10.18203/2349-3291.ijcp20184300.
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Background: Hypoglycemia is one of the important problems encountered in small for gestational age (SGA) neonates. The incidence and risk factors associated with hypoglycemia in the first 48 hours of life in Small for Gestational Age (SGA) Neonates was investigated in this study.Methods: Capillary Blood Glucose was screened by glucostix at 1, 2, 6, 12, 24, and 48 hours of age in 100 SGA neonates fulfilling the inclusion and exclusion criteria.Results: The overall incidence of hypoglycemia in SGA neonates in the study was 24%. The incidence of hypoglycemia was significantly higher in preterm SGA neonates (37.50%) when compared to term SGA neonates (17.65%). The incidence of symptomatic hypoglycemia was 9%. Maximum incidence of hypoglycemia was noted at 2 hours of life. Of the 24 SGA neonates with hypoglycemia, 33.33% had one episode of hypoglycemia, 45.83% had two episodes of hypoglycemia, 12.50% had three episodes of hypoglycemia, 8.33% had four episodes of hypoglycemia. None of the SGA neonate had more than four episodes of hypoglycemia. Early initiation of enteral feeding was significantly associated with decreased incidence of hypoglycemia in SGA neonates. There was no significant correlation between incidence of hypoglycemia in SGA neonates and gender of the baby, parity of mother, mode of delivery and type of IUGR.Conclusions: It is recommended to monitor all SGA neonates especially preterm SGA for hypoglycemia and ensure early initiation of enteral feeding in all SGA neonates.
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Meilyana, Fina, Julistio Djais, and Herry Garna. "Status Gizi Berdasarkan Subjective Global Assessment Sebagai Faktor yang Mempengaruhi Lama Perawatan Pasien Rawat Inap Anak." Sari Pediatri 12, no. 3 (November 23, 2016): 162. http://dx.doi.org/10.14238/sp12.3.2010.162-7.
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Latar belakang. Length of stay (LOS) adalah masa rawat seorang pasien di rumah sakit dihitung sejakpasien masuk rumah sakit dan keluar rumah sakit, yang dipengaruhi oleh faktor usia, komorbiditas, hipermetabolisme,dan kegagalan organ serta defisiensi nutrisi. Status gizi merupakan salah satu komponenyang mempengaruhi biaya perawatan, lama hari perawatan, dan kualitas hidup. Salah satu cara penilaianstatus gizi adalah subjective global assessment (SGA) yang terdiri dari anamnesis dan pemeriksaan fisis yangmencerminkan perubahan metabolik dan fungsional.Tujuan. Penelitian ini bertujuan untuk menilai pengaruh status gizi berdasarkan SGA terhadap lama perawatanpasien rawat inap anak.Metode. Penelitian analitik observasional dengan rancangan kohort prospektif dilakukan selama periodeFebruari - Juni 2010 terhadap 311 pasien yang menderita infeksi akut usia 1 bulan 14 tahun yang dirawatdi ruang perawatan anak kelas III RSUP dr. Hasan Sadikin. Penilaian status gizi berdasarkan SGA dikelompokanmenjadi SGA A (gizi baik), SGA B (malnutrisi ringan + sedang, dan SGA C (malnutrisi berat).Hasil. Berdasarkan penilaian status gizi dengan SGA berturut-turut didapatkan SGA A, SGA B, dan SGAC sebesar 114 (36,7%), 98 (31,5%), dan 99 (31,8%). Dengan menggunakan uji chi square, didapatkanperbedaan lama perawatan yang bermakna (p<0,001) pada kelompok subjek SGA C dibandingkan kelompokSGA B dan SGA A. Berdasarkan analisis multivariat regresi logistik, kelompok SGA C berisiko 2,205 kalilebih tinggi untuk menjalani perawatan lebih lama (RR: 2,205; 95% CI: 1,151-4,227).Kesimpulan. Penelitian ini menunjukkan bahwa status gizi yang dinilai dengan SGA terbukti berpengaruhterhadap lama hari perawatan dan dapat dianjurkan untuk digunakan dalam penilaian status gizi.
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Reinehr, Thomas, Michaela Kleber, and Andre Michael Toschke. "Small for gestational age status is associated with metabolic syndrome in overweight children." European Journal of Endocrinology 160, no. 4 (April 2009): 579–84. http://dx.doi.org/10.1530/eje-08-0914.
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ObjectiveSmall for gestational age (SGA) children are at risk of both later obesity and metabolic syndrome (MetS). However, it is unknown whether obesity or SGA status leads to MetS in these subjects. We hypothesized that overweight children with former SGA status had more present components of the MetS than overweight children with former appropriate for gestational age (AGA) status.MethodsWe analyzed 803 overweight children (4% SGA, mean age 11±0.1 years, body mass index (BMI) 27.3±0.2, SDS-BMI 2.32±0.02) concerning blood pressure, lipids, glucose, and insulin. Oral glucose tolerance tests (oGTT) were performed in all 35 former SGA children and 147 randomly chosen former non-SGA children.ResultsAfter adjustment for age, sex, pubertal stage, and BMI-SDS, former SGA status was significantly related to blood pressure, triglyceride, insulin, and 2 h glucose levels in oGTT. The MetS prevalence was more than doubled in overweight former SGA subjects (40% MetS) compared with overweight former AGA subjects (17% MetS). The corresponding adjusted odds ratio was 4.08 (95% confidence interval 1.48 to 11.22) for SGA compared with AGA children.ConclusionsOverweight former SGA children had an increased risk for the components of the MetS compared with overweight former AGA children. Therefore, SGA status seems to be a risk factor for the MetS independently of weight status. Particularly overweight children with former SGA status should be screened for the MetS.
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De Giuseppe, Rachele, Manuela Bocchi, Silvia Maffoni, Elsa Del Bo, Federica Manzoni, Rosa Maria Cerbo, Debora Porri, and Hellas Cena. "Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience." Nutrients 13, no. 6 (June 5, 2021): 1941. http://dx.doi.org/10.3390/nu13061941.
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Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. Methods. One hundred women (16–44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. Results. Women were divided into “SGA group” vs. “non-SGA group”. The MD was adopted by 71% of women and its adherence was higher in the “non-SGA group” (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the “SGA group” (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. Conclusions. MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation.
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Stefani, Giovanna, Mariana Crestani, Laura Scott, and Thais Steemburgo. "Accuracy of Nutritional Status Assessment Tools for the Diagnosis of Malnutrition in Hospitalized Elderly Cancer Patients." Current Developments in Nutrition 6, Supplement_1 (June 2022): 254. http://dx.doi.org/10.1093/cdn/nzac052.021.
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Abstract Objectives To evaluate in elderly hospitalized patients with cancer the accuracy of the Subjective Global Assessment - Patient-Generated (PG-SGA), PG-SGA short form (SF), Mini Nutritional Assessment (MNA) SF and Global Leadership Initiative on Malnutrition (GLIM) criteria using the handgrip Strength (HGS) and calf circumference (CC) for the diagnosis of malnutrition considering Subjective Global Assessment (SGA) as a reference and, to establish the association of malnutrition with length hospital stays (LOS). Methods This is a cross-sectional study involving elderly inpatients with cancer. Nutritional status was identified within the first 48 hours of admission by SGA, PG-SGA, PG-SGA SF, MNA SF and GLIM (using HGS and CC). Area Under Curve (AUC) by receiver operating characteristic (ROC) curve, Sensitivity (Se), Specificity (Sp) and kappa (k) were analyzed. Association between malnutrition and LOS was investigated by logistic regression analysis, adjusted for confounding variables. Results 155 patients were evaluated [69.8 ± 7.4 years, 60% male and 47,7% of elderly patients were hospitalized for ≥ 5 days]. Malnutrition was diagnosed in 54.2%, 83%, 66%, 70%, 50% and 72% according to SGA, PG-SGA, PG-SGA SF, MNA SF, GLIM (using CC) and GLIM (using HGS), respectively. When we evaluated the accuracy, two tools showed better performance and moderate agreement compared to reference method (SGA): GLIM using CC (AUC: 0.789; Se: 76.2%; Sp: 81.7% and k = 0.574) and PG-SGA SF (AUC: 0.782; Se: 91.7%; Sp: 64.8% and k = 0.576). In logistic regression, the presence of malnutrition by SGA, PG-SGA SF, MNA SF and GLIM criteria, using CC, was significantly associated with LOS ≥ 5 days, but not by PG-SGA and GLIM using HGS. Conclusions The PG-SGA SF and GLIM, using CC, are useful tools for diagnosing malnutrition and were associated with LOS ≥ 5 days in hospitalized elderly cancer patients. Funding Sources Fundo de Incentivo à Pesquisa (FIPE) do Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil. (number# 2019/0708).
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Li, Yajin, Qiong Wang, Xiaoyu Xu, and Huachun Guo. "UHPLC-MS/MS Analysis of the Accumulation and Excretion of Steroidal Glycoalkaloids Consumed by Potato Tuber Moth (Phthorimaea operculella) Larvae under Different Feeding Treatments." Insects 14, no. 1 (December 26, 2022): 26. http://dx.doi.org/10.3390/insects14010026.
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Food poisoning caused by potato glycoside alkaloids (SGA) remains a critical factor that affects potato production safety. The potato tuber moth (Phthorimaea operculella) is a notorious pest that displays good adaptability to SGA in potato tissues. Studies that explore the mechanisms underlying SGA homeostasis in potato tuber moth larvae are urgently needed. In this study, ultra-high-performance liquid chromatography (UHPLC)-triple quadrupole mass spectrometry (MS/MS) was applied to detect the dominant SGA substances α-solanine and α-chaconine in potato leaves and PTM larval tissues. From the highest to lowest SGA concentrations, the potato cultivars studied were ranked as follows: DS47, LS6, DS23 and QS9. To exclude the influence of nutrients within different potato varieties, different SGA containing (0%, 0.1%, 0.2%, 0.3% and 0.4%) the artificial diet treatment groups were added. DS47 and 0.3% SGA-containing artificial diets presented the best conditions for PTM growth, development and reproduction compared to other potato cultivars and artificial diet controls. The potato tuber moth larva tissues were dissected and the SGA content within different tissues were detected using an UHPLC machine. The results showed that α-chaconine was dispersed in the feces, midgut, hindgut, head and cuticle, and α-solanine was distributed only in the feces and midgut. Antibiotic-treated insects exhibited higher concentrations of SGA than the normal microbiome group. Furthermore, the SGA concentrations of 100 newly-hatched PTM larvae and puparia were detected, with both of them found to contain small amounts of SGA. The results showed that ecdysis and the excretion process were effective approaches used by the potato tuber moth to equilibrate internal SGA accumulation. The microorganism-decreased SGA concentrations were excited in their gut. SGA may transfer from adults to the next generation, and SGAs in PTM are inheritable. In this study, we demonstrated that the potato tuber moth possessed an effective method to preliminarily decrease high SGA accumulation in potato.
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Allard, Johane P., Heather Keller, Anastasia Teterina, Khursheed N. Jeejeebhoy, Manon Laporte, Donald R. Duerksen, Leah Gramlich, et al. "Factors associated with nutritional decline in hospitalised medical and surgical patients admitted for 7 d or more: a prospective cohort study." British Journal of Nutrition 114, no. 10 (September 15, 2015): 1612–22. http://dx.doi.org/10.1017/s0007114515003244.
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AbstractThis prospective cohort study was conducted in eighteen Canadian hospitals with the aim of examining factors associated with nutritional decline in medical and surgical patients. Nutritional decline was defined based on subjective global assessment (SGA) performed at admission and discharge. Data were collected on demographics, medical information, food intake and patients’ satisfaction with nutrition care and meals during hospitalisation; 424 long-stay (≥7 d) patients were included; 38 % of them had surgery; 51 % were malnourished at admission (SGA B or C); 37 % had in-hospital changes in SGA; 19·6 % deteriorated (14·6 % from SGA A to B/C and 5 % from SGA B to C); 17·4 % improved (10·6 % from SGA B to A, 6·8 % from SGA C to B/A); and 63·0 % patients were stable (34·4 % were SGA A, 21·3 % SGA B, 7·3 % SGA C). One SGA C patient had weight loss ≥5 %, likely due to fluid loss and was designated as stable. A subset of 364 patients with admission SGA A and B was included in the multiple logistic regression models to determine factors associated with nutritional decline. After controlling for SGA at admission and the presence of a surgical procedure, lower admission BMI, cancer, two or more diagnostic categories, new in-hospital infection, reduced food intake, dissatisfaction with food quality and illness affecting food intake were factors significantly associated with nutritional decline in medical patients. For surgical patients, only male sex was associated with nutritional decline. Factors associated with nutritional decline are different in medical and surgical patients. Identifying these factors may assist nutritional care.
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Yu, Gang, Changxing Li, Lei Zhang, Guangtao Zhu, Shoaib Munir, Caixue Shi, Hongyan Zhang, et al. "An allelic variant of GAME9 determines its binding capacity with the GAME17 promoter in the regulation of steroidal glycoalkaloid biosynthesis in tomato." Journal of Experimental Botany 71, no. 9 (January 14, 2020): 2527–36. http://dx.doi.org/10.1093/jxb/eraa014.
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Abstract Steroidal glycoalkaloids (SGAs) are cholesterol-derived molecules found in the family Solanaceae. SGA content varies among different plant species and varieties. However, the genetic mechanisms regulating SGA content remain unclear. Here, we demonstrate that genetic variation in GLYCOALKALOID METABOLISM 9 (GAME9) is responsible for the variation in SGA content in tomato (Solanum lycopersicum). During a sequential analysis we found a 1 bp substitution in the AP2/ERF binding domain of GAME9. The 1 bp substitution in GAME9 was significantly associated with high SGA content and determined the binding capacity of GAME9 with the promoter of GAME17, a core SGA biosynthesis gene. The high-SGA GAME9 allele is mainly present in S. pimpinellifolium and S. lycopersicum var. cerasiforme populations and encodes a protein that can bind the GAME17 promoter. In contrast, the low-SGA GAME9 allele is mainly present in the big-fruited varieties of S. lycopersicum and encodes a protein that shows weak binding to the GAME17 promoter. Our findings provide new insight into the regulation of SGA biosynthesis and the factors that affect the accumulation of SGA in tomato.
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Luong, Rebecca, Marcellinus Kim, Alice Lee, and Sharon Carey. "Assessing nutritional status in a cohort of liver cirrhosis outpatients: A prospective cross-sectional study." Nutrition and Health 26, no. 1 (November 28, 2019): 19–25. http://dx.doi.org/10.1177/0260106019888362.
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Background: Malnutrition impairs prognosis in patients with liver cirrhosis (LC). There is limited research exploring the prevalence of malnutrition in patients with LC in an Australian population and in outpatient settings. Aims: One aim of this study was to investigate the prevalence of malnutrition in patients with LC in an outpatient liver clinic at a tertiary metropolitan hospital in Sydney, Australia, and explore other factors that may be associated with malnutrition. The second aim was to compare different versions of Subjective Global Assessment (SGA). Methods: This cross-sectional study evaluated the nutritional status of 42 prospectively recruited participants by SGA, SGA modified for liver disease (SGA-LD) and patient-generated SGA (PG-SGA). Anthropometric measures and handgrip strength (HGS) were also measured for comparison. Clinical and demographic data were compared with nutritional status. Results: SGA, SGA-LD and PG-SGA yielded the same prevalence of malnutrition of 40% with very good agreement (kappa value = 1.00). Malnourished patients had a lower median HGS% of normal than those who were well-nourished. Malnourished patients also had anthropometric measurements trending towards the lower percentiles of a healthy population. Nutritional status was significantly associated with ethnicity ( p = 0.02) and PG-SGA score ( p < 0.0001). Conclusion: The present study showed that nearly half of our study population were malnourished (40%). Thus, nutrition intervention in terms of nutrition support could improve patient outcomes. It appears that the standard SGA is suitable to assess nutritional status in patients in the early stages of LC compared to more time-consuming SGA versions.
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Ahmad, Norain, Rosnah Sutan, Azmi Mohd Tamil, and Noriah Hajib. "Growth patterns and nutritional status of small for gestational age infants in Malaysia during the first year of life." Child Health Nursing Research 27, no. 4 (October 31, 2021): 317–27. http://dx.doi.org/10.4094/chnr.2021.27.4.317.
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Purpose: This study aimed to identify small for gestational age (SGA) infants' growth patterns, nutritional status, and associated factors.Methods: This prospective cohort study was conducted at primary-care child health clinics in Greater Kuala Lumpur, Malaysia. The sample consisted of infants who fulfilled the criteria and were born in 2019. The anthropometric data of infants were assessed at birth and at 1, 3, 6, 9, and 12 months.Results: A total of 328 infants were analysed. In total, 27.7%(n=91) of the subjects were SGA infants, and 237 of them were not. Significant differences in the median weight-for-age and length-for-age z-scores were observed between SGA and non-SGA infants at birth, 1 month, 6 months, and 12 months. There was a significant difference between the growth patterns of SGA and non-SGA infants. Birth weight and sex significantly predicted the nutritional status(stunting and underweight) of SGA infants during their first year of life.Conclusion: SGA infants can catch up to achieve normal growth during their first year of life. Even though the nutritional status of SGA infants trends worse than non-SGA infants, adequate infant birth weight monitoring and an emphasis on nutritional advice are crucial for maintaining well-being.
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Wang, Xiulian, Jianzhen Zhu, Chong Guo, Huiqing Shi, Dan Wu, Fanfan Sun, Li Shen, et al. "Growth of infants and young children born small for gestational age: growth restriction accompanied by overweight." Journal of International Medical Research 46, no. 9 (July 15, 2018): 3765–77. http://dx.doi.org/10.1177/0300060518779305.
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Objectives To compare growth profiles of children born small for gestational age (SGA) with those born the appropriate size for gestational age (AGA), and examine expected growth patterns for SGA in early childhood. Methods A survey on 23,871 SGA children was conducted in Shanghai. Data were collected at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, and 60 months of age (+30 days). A check-up included assessments of weight, height, and head circumference. Results At 5 years old, weight, height, and head circumference were lower in SGA children compared with AGA children. The proportions of overweight and obesity of SGA children at 4 to 18 months after birth were significantly higher than those in AGA children, with higher proportions in boys than in girls. There was no correlation between overweight at 5 years old and overweight before 2 years old in SGA children. Conclusions Children born SGA remain shorter and lighter, with a smaller head circumference at 5 years old compared with AGA children. At 4 to 18 months after birth, there is a high incidence of overweight and obesity in SGA children. Overweight and obesity in SGA boys are more serious than those in SGA girls.
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Farsetti, Daniele, Francesca Pometti, Grazia Maria Tiralongo, Damiano Lo Presti, Ilaria Pisani, Giulia Gagliardi, Barbara Vasapollo, Gian Paolo Novelli, and Herbert Valensise. "Fetal Umbilical Vein Flow in the Classification of Fetuses with Growth Restriction." Reproductive Medicine 2, no. 1 (March 9, 2021): 50–56. http://dx.doi.org/10.3390/reprodmed2010006.
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Objectives: To assess umbilical vein (UV) blood flow in fetal growth restriction (FGR) and in pregnancy with small for gestational age (SGA) fetus. To evaluate the predictive capacity of UV blood flow (QUV) in the discrimination of SGA fetuses from FGR before and after 32 weeks of pregnancy. Methods: Sixty-five women with a recent diagnosis of FGR or SGA fetuses were enrolled and underwent a complete fetal Doppler examination comprehending QUV. We collected SGA (n = 34), early-FGR (n = 9), and late-FGR (n = 22) fetuses. Results: UV diameter was lower in early and late-FGR compared to SGA, while time-averaged maximum velocity (TAMXV) was lower only in early-FGR. UV blood flow (QUV) and QUV corrected for estimated fetal weight (cQUV) were significantly lower in early-FGR and late-FGR compared to SGA. The receiver operating characteristic (ROC) curves analysis of cQUV showed a significant predictive capacity for SGA diagnosis before and after 32 weeks. Conclusions: The evaluation of UV blood flow allows distinguishing SGA fetuses from FGR. The assessment of UV flow should be taken into consideration in future research of new parameters to differentiate SGA from FGR.
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Østgård, Heidi Furre, Jon Skranes, Marit Martinussen, Geir W. Jacobsen, Ann-Mari Brubakk, Torstein Vik, Are H. Pripp, and Gro C. C. Løhaugen. "Neuropsychological Deficits in Young Adults Born Small-for-Gestational Age (SGA) at Term." Journal of the International Neuropsychological Society 20, no. 3 (February 24, 2014): 313–23. http://dx.doi.org/10.1017/s1355617714000034.
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AbstractReduced IQ, learning difficulties and poor school performance have been reported in small-for-gestational-age (SGA) subjects. However, few studies include a comprehensive neuropsychological assessment. Our aim was to study neuropsychological functioning in young adults born SGA at term. A comprehensive neuropsychological test battery was administered to 58 SGA subjects (birth weight <10th centile) born at term, and 81 term non-SGA controls (birth weight ≥10th centile). The SGA group obtained significantly (p< .01) lower scores on the attention, executive and memory domains compared to non-SGA controls and showed higher risk of obtaining scores below −1.5SDon the memory domain (odds ratio = 13.3, 95% confidence interval: 1.57, 112.47). At a subtest level, the SGA group obtained lower scores on most neuropsychological tests, with significant differences on 6 of 46 measures: the Trail Making Test 3 (letter sequencing), the Wechsler Memory Scale mental control and the auditory immediate memory scale, the Design Fluency, the Stroop 3 (inhibition) and the Visual Motor Integration (VMI) motor coordination subtest. Young adults born SGA score more poorly on neuropsychological tests compared with non-SGA controls. Differences were modest, with more significant differences in the memory domain. (JINS, 2014,20, 1–11)
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Chang, Hung-Yang, Jen-Shiu Chiang Chiau, Jui-Hsing Chang, Chyong-Hsin Hsu, Chia-Ying Lin, Mary Hsin-Ju Ko, and Hung-Chang Lee. "Characteristics of Gut Microbiota in Small for Gestational Age Infants with Very Low Birth Weight." Nutrients 14, no. 23 (December 4, 2022): 5158. http://dx.doi.org/10.3390/nu14235158.
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Small for gestational age (SGA) birth is associated with high rates of mortality and morbidity in preterm infants. The aim of this preliminary observational study was to investigate the difference in gut microbiota between SGA and appropriate for gestational age (AGA) preterm infants with very low birth weight (VLBW). We included 20 VLBW preterm infants (SGA, n = 10; AGA, n = 10) in this study. Stool samples were collected on days 7, 14, and 30 after birth. We performed 16S ribosomal DNA sequencing to compare microbiota composition between both groups. The SGA group exhibited a lower abundance of Klebsiella on day 14 (SGA, 0.57%; AGA, 7.42%; p = 0.037). On day 30, the SGA group exhibited a lower abundance of Klebsiella (SGA 3.76% vs. AGA 16.05%; p = 0.07) and Enterobacter (SGA 5.09% vs. AGA 27.25%; p = 0.011) than the AGA group. Beta diversity demonstrated a separation of the bacterial community structure between both groups on day 30 (p = 0.019). The present study revealed that a distinct gut microbiota profile gradually develops in SGA preterm infants with VLBW during the early days of life. The role of changes in gut microbiota structure warrants further investigation.
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Ruchob, Rungnapa, Julienne N. Rutherford, and Aleeca F. Bell. "A Systematic Review of Placental Biomarkers Predicting Small-for-Gestational-Age Neonates." Biological Research For Nursing 20, no. 3 (February 28, 2018): 272–83. http://dx.doi.org/10.1177/1099800418760997.
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Background: Neonates born small for gestational age (SGA) face increased risk of neonatal mortality, childhood developmental problems, and adult disease. The placenta is a key factor in SGA development because of its multiple biological processes that underlie fetal growth. However, valid and reliable placental biomarkers of SGA have not been determined. Objectives: The objective of this article was to systematically identify and review studies examining associations between placental biomarkers and SGA and assess those biomarkers’ predictive value. Methods: Use of the matrix method and the PRISMA guidelines ensured systematic identification of relevant articles based on selection criteria. PubMed, CINAHL, and EMBASE were searched for English articles published in 2005–2016 that addressed relationships between placental biomarkers and SGA. Results: The search captured 466 articles; 13 met selection criteria. The review identified 14 potential placental biomarkers for SGA, with placental growth factor and soluble fms-like tyrosine kinase 1 being the most commonly studied. However, findings for these and other biomarkers have often been contradictory. Thus, no placental biomarkers have been confirmed as reliable for predicting SGA. Conclusion: The inconsistent findings suggest low placental biomarker reliability, perhaps due to the multifactorial nature of SGA. This review is novel in its focus on identifying potential placental biomarkers for SGA, producing a better understanding of how placental function underlies fetal growth. Nevertheless, use of placental biomarkers alone may not be adequate for predicting SGA. Therefore, combinations of biomarkers and other predictive tests should be evaluated for their ability to predict risk of SGA.
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Jensen, Erik A., Elizabeth E. Foglia, Kevin C. Dysart, Rebecca A. Simmons, Zubair H. Aghai, Alison Cook, Jay S. Greenspan, and Sara B. DeMauro. "Adverse effects of small for gestational age differ by gestational week among very preterm infants." Archives of Disease in Childhood - Fetal and Neonatal Edition 104, no. 2 (May 5, 2018): F192—F198. http://dx.doi.org/10.1136/archdischild-2017-314171.
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ObjectiveTo characterise the excess risk for death, grade 3–4 intraventricular haemorrhage (IVH), bronchopulmonary dysplasia (BPD) and stage 3–5 retinopathy of prematurity independently associated with birth small for gestational age (SGA) among very preterm infants, stratified by completed weeks of gestation.MethodsRetrospective cohort study using the Optum Neonatal Database. Study infants were born <32 weeks gestation without severe congenital anomalies. SGA was defined as a birth weight <10th percentile. The excess outcome risk independently associated with SGA birth among SGA babies was assessed using adjusted risk differences (aRDs).ResultsOf 6708 infants sampled from 717 US hospitals, 743 (11.1%) were SGA. SGA compared with non-SGA infants experienced higher unadjusted rates of each study outcome except grade 3–4 IVH among survivors. The excess risk independently associated with SGA birth varied by outcome and gestational age. The highest aRD for death (0.27; 95% CI 0.13 to 0.40) occurred among infants born at 24 weeks gestation and declined as gestational age increased. In contrast, the peak aRDs for BPD among survivors (0.32; 95% CI 0.20 to 0.44) and the composites of death or BPD (0.35; 95% CI 0.24 to 0.46) and death or major morbidity (0.35; 95% CI 0.24 to 0.45) occurred at 27 weeks gestation. The risk-adjusted probability of dying or developing one or more of the evaluated morbidities among SGA infants was similar to that of non-SGA infants born approximately 2–3 weeks less mature.ConclusionThe excess risk for neonatal morbidity and mortality associated with being born SGA varies by adverse outcome and gestational age.
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De Groot, Lynette M., Gahee Lee, Antoinette Ackerie, and Barbara S. van der Meij. "Malnutrition Screening and Assessment in the Cancer Care Ambulatory Setting: Mortality Predictability and Validity of the Patient-Generated Subjective Global Assessment Short form (PG-SGA SF) and the GLIM Criteria." Nutrients 12, no. 8 (July 30, 2020): 2287. http://dx.doi.org/10.3390/nu12082287.
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Background: A valid malnutrition screening tool (MST) is essential to provide timely nutrition support in ambulatory cancer care settings. The aim of this study is to investigate the validity of the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) and the new Global Leadership Initiative on Malnutrition (GLIM) criteria as compared to the reference standard, the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: Cross-sectional observational study including 246 adult ambulatory patients with cancer receiving in-chair intravenous treatment at a cancer care centre in Australia. Anthropometrics, handgrip strength and patient descriptive data were assessed. Nutritional risk was identified using MST and PG-SGA SF, nutritional status using PG-SGA and GLIM. Sensitivity (Se), specificity (Sp), positive and negative predictive values and kappa (k) were analysed. Associations between malnutrition and 1-year mortality were investigated by Cox survival analyses. Results: A PG-SGA SF cut-off score ≥5 had the highest agreement when compared with the PG-SGA (Se: 89%, Sp: 80%, k = 0.49, moderate agreement). Malnutrition risk (PG-SGA SF ≥ 5) was 31% vs. 24% (MST). For malnutrition according to GLIM, the Se was 76% and Sp was 73% (k = 0.32, fair agreement) when compared to PG-SGA. The addition of handgrip strength to PG-SGA SF or GLIM did not improve Se, Sp or agreement. Of 100 patients who provided feedback, 97% of patients found the PG-SGA SF questions easy to understand, and 81% reported that it did not take too long to complete. PG-SGA SF ≥ 5 and severe malnutrition by GLIM were associated with 1-year mortality risk. Conclusions: The PG-SGA SF and GLIM criteria are accurate, sensitive and specific malnutrition screening and assessment tools in the ambulatory cancer care setting. The addition of handgrip strength tests did not improve the recognition of malnutrition or mortality risk.
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Giorgione, Veronica, Corey Briffa, Carolina Di Fabrizio, Rohan Bhate, and Asma Khalil. "Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts." Journal of Clinical Medicine 10, no. 4 (February 8, 2021): 643. http://dx.doi.org/10.3390/jcm10040643.
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Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.
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Rapaport, Robert, Peter A. Lee, Judith L. Ross, Paul Saenger, Vlady Ostrow, and Giuseppe Piccoli. "Three years of growth hormone therapy in children born small for gestational age: results from the ANSWER Program." Endocrine Connections 7, no. 10 (October 2018): 1096–104. http://dx.doi.org/10.1530/ec-18-0286.
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Growth hormone (GH) is used to treat short stature and growth failure associated with growth disorders. Birth size and GH status variably modulate response to GH therapy. The aim of this study was to determine the effect of birth size on response to GH therapy, and to determine the impact of GH status in patients born small for gestational age (SGA) on response to GH therapy. Data from the prospective, non-interventional American Norditropin Studies: Web-Enabled Research (ANSWER) Program was analyzed for several growth outcomes in response to GH therapy over 3 years. GH-naïve children from the ANSWER Program were included in this analysis: SGA with peak GH ≥10 ng/mL (20 mIU/L), SGA with peak GH <10 ng/mL (20 mIU/L), isolated growth hormone deficiency (IGHD) born SGA, IGHD not born SGA and idiopathic short stature. For patients with IGHD, those who did not meet criteria for SGA at birth showed greater improvements in height SDS and BMI SDS than patients with IGHD who met criteria for SGA at birth. For patients born SGA, response to GH therapy varied with GH status. Therefore, unlike previous guidelines, we recommend that GH status be established in patients born SGA to optimize GH therapy.
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Palatnik, Anna, Sarah De Cicco, Liyun Zhang, Pippa Simpson, Judith Hibbard, and Leonard E. Egede. "The Association between Advanced Maternal Age and Diagnosis of Small for Gestational Age." American Journal of Perinatology 37, no. 01 (August 20, 2019): 037–43. http://dx.doi.org/10.1055/s-0039-1694775.
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Abstract Objectives To identify whether advanced maternal age (AMA), defined as age ≥35 years old, is independently associated with small for gestational age (SGA). Study Design This was a retrospective cohort of births from the National Vital Statistics System in the United States from 2009 to 2013. Women were categorized based on four age groups at the time of delivery: 20 to 29, 30 to 34, 35 to 39, and ≥40 years old. The primary outcome of SGA < 10th and SGA < 5th percentiles was compared between the four groups using both univariable and multivariable analyses to determine whether maternal age was associated with SGA independent of parity. Results A total of 17,031,005 births were eligible for analysis, with 2,705,501 births to AMA women. In multivariable analyses, maternal age of 30 to 34, compared with 20 to 29, was associated with lower rates of SGA < 10th and <5th percentiles (adjusted odds ratio [aOR] = 0.95; 95% confidence interval [CI]: 0.95–0.96 and aOR = 0.97; 95% CI: 0.96–0.98, respectively). The AMA of 35 to 39, compared with 20 to 29, was associated with lower rates of SGA < 10th percentile and unchanged rates of SGA < 5th percentile (aOR = 0.97; 95% CI: 0.96–0.98 and aOR = 1; 95% CI: 0.99–1.01, respectively). In contrast, AMA of ≥40, compared with age 20 to 29, was associated with higher rates of both SGA < 10th and <5th percentiles (aOR = 1.06; 95% CI: 1.04–1.07 and aOR = 1.14; 95% CI: 1.12–1.16, respectively). A significant association was found between maternal age and parity toward the risk of SGA (p < 0.001). Nulliparous women ≥30 years old but not multiparous women had higher rates of SGA < 10th and SGA < 5th percentiles compared with nulliparous women in the age group of 20 to 29. In contrast, both nulliparous and multiparous women age ≥40 years old had an increased risk for SGA < 5th percentile compared with all women in the age group of 20 to 29. Conclusion Nulliparous women aged 30 years and older have higher risk of SGA < 10th and SGA < 5th percentiles compared with nulliparous women age 20 to 29. In contrast, both nulliparous and multiparous women age 40 years and older have an increased risk of SGA < 5th percentile compared with all women in the age group of 20 to 29.
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Shusterman, Michael, Gagandeep Brar, Kelsey Klute, Victoria Cooley, Alexandra Rosenstock, Eun Kyeong Hwang, Dina Elmonshed, et al. "Phase II randomized controlled trial (RCT) of medical intensive nutrition therapy (MINT) to improve chemotherapy (CT) tolerability in malnourished patients with solid tumor malignancies." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 12090. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.12090.
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12090 Background: Malnutrition is an underrecognized predictor of inferior cancer related outcomes. Subjective global assessment (SGA), a brief validated survey for malnutrition, may predict increased CT toxicity. This phase II RCT was performed to validate SGA as a predictive tool for malnutrition and to evaluate the impact of MINT on CT associated toxicity. Methods: CT naive pts screened by SGA were assigned to well-nourished (SGA A) or malnourished (SGA B/C) cohorts. Both cohorts were followed for CT delivery, toxicity, quality of life (QOL) by FACT-G, biomarkers, radiology, and survival. SGA B/C pts, stratified by regimen/disease, were randomized 1:1 to MINT vs. usual care. The MINT cohort received weekly registered dietician counseling and symptom assessment over the 8-week study period. Percent standard and planned CT doses were calculated. Wilcoxon rank sum tests were used for differences between groups, log-rank tests for survival, and multivariable linear regression for adjusted comparisons. Results: 186 eligible pts were enrolled (94 SGA A, 92 SGA B/C). SGA A were younger (median age [range]; 63 [22, 89] vs. 70 [22, 91], p = 0.011) and more fit (ECOG 0-1; 96.8% vs. 72.8%, p < 0.001). Baseline QOL was higher for SGA A (median [range], 87 [34, 115]) vs SGA B/C (70 [31, 101], p < 0.001). SGA A was associated with higher CT delivery: median proportion of planned CT (1 [Q1 0.87, Q3 1] vs 0.94 [0.70, 1], p = 0.022) and standard CT (0.91 [0.72, 1] vs. 0.74 [0.57, 0.95] p < 0.001). Adjusted for age/ECOG, SGA A remained associated with > 80% of planned (OR 2.32, p = 0.05) and standard (OR 2.33, p = 0.04) CT. SGA B/C pts (n = 92) were randomized to MINT vs usual care: median nutrition encounters MINT 5.5 vs. usual care 0.5; we observed no differences in CT delivery: median proportion of planned CT (0.91 [0.69, 1] vs. 0.94 [0.74, 1], p = 0.84) and standard CT (0.75 [0.58, 0.96] vs 0.71 [0.52, 0.99], p = 0.59). SGA A was associated with a longer 12-month survival (77.8% [95% CI 69.6%, 86.9%]) vs. B/C (53.3% [42.8%, 66.4%], p < 0.0001; 12-month survival was similar for MINT (52.3% [38.1%, 71.9%]) vs usual care (54.4% [40.2%, 73.6%], p = 0.58). Conclusions: SGA is a validated tool to characterize malnutrition in pts receiving CT. Malnourished pts received significantly less CT, experienced worse baseline QOL, and had worse 12-month survival. Intensive medical nutrition therapy was not associated with differences in CT associated toxicity. Novel nutritional interventions are still needed to improve pt outcomes.
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Hadar, Omer, Eyal Sheiner, and Tamar Wainstock. "The Association Between Delivery of Small-for-Gestational-Age Neonate and Their Risk for Long-Term Neurological Morbidity." Journal of Clinical Medicine 9, no. 10 (October 2, 2020): 3199. http://dx.doi.org/10.3390/jcm9103199.
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Small-for-gestational-age (SGA) is defined as a birth weight below the 10th or below the 5th percentile for a specific gestational age and sex. Previous studies have demonstrated an association between SGA neonates and long-term pediatric morbidity. In this research, we aim to evaluate the possible association between small-for-gestational-age (SGA) and long-term pediatric neurological morbidity. A population-based retrospective cohort analysis was performed, comparing the risk of long-term neurological morbidities in SGA and non-SGA newborns delivered between the years 1991 to 2014 at a single regional medical center. The neurological morbidities included hospitalizations as recorded in hospital records. Neurological hospitalization rate was significantly higher in the SGA group (3.7% vs. 3.1%, OR = 1.2, 95% CI 1.1–1.3, p < 0.001). A significant association was noted between neonates born SGA and developmental disorders (0.2% vs. 0.1%, OR = 2.5, 95% CI 1.7–3.8, p < 0.001). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of neurological morbidity in the SGA group (log-rank p < 0.001). In the Cox proportional hazards model, which controlled for various Confounders, SGA was found to be an independent risk factor for long-term neurological morbidity (adjusted hazard ratio( HR) = 1.18, 95% CI 1.07–1.31, p < 0. 001). In conclusion, we found that SGA newborns are at an increased risk for long-term pediatric neurological morbidity.
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Gabbay-Benziv, Rinat, Amir Aviram, Ron Bardin, Eran Ashwal, Nir Melamed, Liran Hiersch, Arnon Wiznitzer, Yariv Yogev, and Eran Hadar. "Prediction of Small for Gestational Age: Accuracy of Different Sonographic Fetal Weight Estimation Formulas." Fetal Diagnosis and Therapy 40, no. 3 (2016): 205–13. http://dx.doi.org/10.1159/000443881.
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Objective: To compare the accuracy of various sonographic estimated fetal weight (sEFW) formulas for the prediction of small for gestational age (SGA) neonates. Methods: A retrospective analysis of 6,126 fetal biometrical measurements performed within 3 days of delivery. SGA prediction was evaluated for various sEFW formulas by calculating the sensitivity, specificity, positive/negative predictive value (PPV/NPV), likelihood ratio (+LR/-LR), overall accuracy and area under the receiver operating characteristic curve (AUC). Systematic error, random error, proportion of estimates >10% of birth weights, actual and absolute weight differences were compared between SGA and non-SGA neonates. Results: Overall, 638 (10.4%) neonates were SGA. There was considerable variation among formulas in sensitivity (mean ± SD, 62 ± 14.4%; range, 32.4-91.2), PPV (72.5 ± 10.7%; 45.8-95.6) and +LR (24.2 ± 10.9; 7.2-57.3), mild variation in specificity (96.6 ± 2.7%; 87.4-99.4), NPV (94.6 ± 5.3%; 72.2-98.9) and -LR (0.4 ± 0.1; 0.1-0.7) and minimal variation in AUC (mean, 0.93; range, 0.91-0.93). The majority of formulas had a lower accuracy for the SGA neonates, with systematic error and random error ranging from -4.2 to 14.3% and from 8.4 to 12.9% for SGA, and from -8.7 to 16.1% and from 7.2 to 10.5% for non-SGA, respectively. Conclusion: sEFW formulas differ in their accuracy for SGA prediction. In our population, the most accurate formula for SGA prediction was Hadlock's formula utilizing femur length, abdominal and head circumference.
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McCarton, Cecelia M., Ina F. Wallace, Michael Divon, and Herbert G. Vaughan. "Cognitive and Neurologic Development of the Premature, Small for Gestational Age Infant Through Age 6: Comparison by Birth Weight and Gestational Age." Pediatrics 98, no. 6 (December 1, 1996): 1167–78. http://dx.doi.org/10.1542/peds.98.6.1167.
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Objective. To compare the neurologic and cognitive outcomes of 129 premature small for gestational age (SGA) infants with 300 premature appropriate for gestational age (AGA) infants through 6 years of age. Design. Infants born at ≤37 weeks gestational age and ≤2500 g with birth weight 2 standard deviations or more below the mean birth weight for gestational age were categorized as SGA. Cognitive and neurologic outcomes of SGA and AGA prematures at 1, 2, 3, and 5 and/or 6 years of age were compared when the infants were stratified by gestational age in 2-week intervals or by birth weight in 500-g intervals. The association between SGA/AGA and neurologic status on cognitive outcomes at each age was also examined. Results. SGA infants had significantly poorer cognitive scores at each age when compared with AGA infants of similar gestational ages. Normal neurologic status was more likely at all assessments for the AGA than for SGA infants of comparable gestational age. There were no differences between SGA and AGA children in cognitive or neurologic outcomes at any age when grouped by birth weight. Cognitive impairment was closely associated with neurologic abnormality in both SGA and AGA groups. There was, nevertheless, a significant effect of SGA on cognitive outcome independent of neurologic status at all ages except 3 years. Conclusions. Irrespective of degree of prematurity, SGA infants are at greater risk for neurodevelopmental impairment than are equally premature AGA infants. The cognitive impairment can be largely, but not entirely, attributed to a higher incidence of neurologic abnormalities in the SGA infants at each gestational age.
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Ester, Wietske A., Joyce B. van Meurs, Nicolette J. Arends, André G. Uitterlinden, Maria A. de Ridder, and Anita C. Hokken-Koelega. "The −G1245A IGF1 polymorphism is related with small head size and less brain sparing in small for gestational age born children." European Journal of Endocrinology 160, no. 4 (April 2009): 549–55. http://dx.doi.org/10.1530/eje-08-0647.
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ContextSmall for gestational age (SGA) subjects experience pre- and postnatal growth restriction, which might be influenced by polymorphisms in the IGF1 gene. The well-known −841(CA)n/192 bp polymorphism has been associated with birth size, cardiovascular disease, and IGF-1 levels, and is in linkage disequilibrium with the −G1245A single nucleotide polymorphism (SNP; rs35767).ObjectiveTo associate the −G1245A SNP with head circumference (HC) and brain sparing (a greater head compared with height SDS) in short SGA and SGA catch-up subjects.DesignGene association study.PatientsWe studied 635 SGA subjects out of which 439 remained short and 196 had a postnatal height >−2.00 SDS.MeasurementsThe −G1245A SNP IGF1 gene polymorphism and head size.ResultsAll SGA subjects had a postnatal head size below the population mean (−1.01 SDS, P<0.001). Whereas SGA catch-up subjects had a head size that was in proportion with their height, short SGA subjects displayed extensive brain sparing (HC – height: SGA CU: 0.01 versus short SGA: 1.75 SDS, P<0.001). The most severely SGA born subjects had a 0.4 SDS smaller postnatal head size and 0.6 SDS less brain sparing when carrying the −1245 A-allele in contrast to G-allele carriers (P=0.03). The association between the −G1245A SNP and head size remained significant after correction for birth weight and postnatal height SDS (P=0.03). Birth weight, birth length and postnatal height SDS were not related with the – G1245A SNP.ConclusionsThe −1245 A-allele of the IGF1 promoter SNP is associated with a small head size and less brain sparing in SGA born subjects and particularly those with the lowest birth weight.
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Wasiluk, Alicja, Milena Dabrowska, Joanna Osada, Marek Szczepanski, Janusz Rogier Warda, and Elwira Agata Jasinska. "Morphological Parameters of Blood Platelets in Small for Gestational Age Newborns." Blood 114, no. 22 (November 20, 2009): 4466. http://dx.doi.org/10.1182/blood.v114.22.4466.4466.
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Abstract Abstract 4466 Platelets demonstrate many activities, e.g. hemostasis, integrity of blood vessels and phagocytosis. Hemostasis in newborns is characterized by a low efficiency in comparison to adults. The regulation of fetal growth is multifactorial and complex. Intrauterine fetal conditions, as well as maternal and environmental factors can lead to intrauterine growth restriction (IUGR). In small for gestational age (SGA) newborns, platelet dysfunction may be more expressed. On the other hand, there are some data indicating that blood platelet functions have some relation to their morphology. We have concentrated our attention on the determination of the count and morphological parameters of blood platelets in SGA newborns. Sixty-one SGA newborns: 31 girls and 30 boys were introduced to our study. They fulfilled all the criteria for SGA newborns, including clinical state and laboratory findings. The newborns were divided into two groups: < 5th centile – 35, and < 10th centile – 26 newborns. The birth weight for females ranged from 1850 to 2780 g and for male newborns from 2000 to 2900 g, at 37-41 weeks gestation. The Apgar score ranged from 8 to 10 points at 1-5 minutes of life. 22 full term newborns (FTN) were introduced to our study. Blood samples were collected from the umbilical artery within 5 minutes of cutting the umbilical cord. The first 0.5 ml of blood was discarded prior to collecting the blood sample for analysis. Within 10 minutes, the blood was transferred to the laboratory, and the platelet count and morphological parameters were determined using a hematologic analyzer, Advia TM 120 System. The platelet count in SGA newborns was lower than in FTN 238 × 103 /μL vs. 282 × 103 /μL, females demonstrated a higher number of platelets than males, SGA 243 × 103 /μL vss 231 × 103 /μL, FTN 311 × 103 /μL vss 258 × 103 /μL. In SGA, newborns < 5th centile 218 × 103 /μL, < 10th centile 263 × 103 /μL. MPV (mean platelet volume) was nearly the same in both groups SGA 8.1 fl, FTN 7.8 fl, gender did not exhibit any effect on MPV in the tested newborns: SGA female 7.9 fl, male 8.4 fl, FTN: female 7.9 fl, male 7.8 fl. The IUGR index did not affect MPV: < 5th centile 8.2 fl, < 10th centile 8.0 fl. PCT (platelet hematocrit) in SGA 0.19 %, in FTN 0.22%. Practically no difference was noted in SGA between female 0.19 %, male 0,18 %; whereas, in FTN female 0.24 %, male 0.21 %. SGA newborns < 5th centile 0.18 %, < 10th centile 0.20 %. PDW (platelet anisocytosis) index was the same in SGA 47 % and FTN 46 %. Higher values were observed in female 48 %, male 45 % SGA newborns, in FTN female 49 %, male 44 %. An evident decrease of PDW was found in SGA newborns < 5th centile 43 %, < 10th centile 52 %. The large platelets (LP) are significantly lower in SGA newborns (4.75 %), in comparison to FTN (6.23 %). Male newborns demonstrated a decrease in the percentage of LP, in SGA: male 4.2 %, female 5.3 %, in FTN: male 4.5 %, female 8.3 %. In SGA newborns < 5th centile 4.9 %, < 10th centile 4.3 %. Some authors suggest that platelet count is related to birth weight, and the degree of placental dysfunction corresponds to our findings in SGA newborns. One can suggest megakaryocytes are not able to produce a satisfactory platelet count. Small differences in the platelet count in relation to gender may result from restricted maturity of the thrombopoietic system. Therefore, it may predispose to a higher risk of bleeding tendency. A low number of LP may increase this risk. An increase of MPV in SGA newborns may indicate platelet consumption and activation. Lower PCT in SGA newborns results from a decreased platelet count. PDW may be used as a marker for bacteriaemia, schistocytosis, or platelet consumption. Evidently, a lower percentage of LP may be considered a symptom of thrombopoiesis immaturity. Our results in the SGA newborns may indicate incomplete development of thrombopoiesis. Disclosures: No relevant conflicts of interest to declare.
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YILDIZ, Duran, Burak CERAN, Ufuk ÇAKIR, Ali Ulaş TUĞCU, and Cüneyt TAYMAN. "Effects of being small for gestational age on morbidities of prematurity." Anadolu Kliniği Tıp Bilimleri Dergisi 27, no. 3 (September 27, 2022): 287–92. http://dx.doi.org/10.21673/anadoluklin.1096789.
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Amaç: Gebelik yaşına göre düşük doğum ağırlığı (small for gestational age: SGA) olan prematüre bebeklerin prematüreliğe ek olarak hangi morbiditeler açısından daha riskli olduğu konusundaki kanıtlar yetersizdir. Çalışmamızda gebelik haftası <32 hafta olan SGA prematüre bebeklerin morbidite ve mortalite açısından risklerinin değerlendirilmesi amaçlanmıştır.Yöntemler: Gebelik haftası <32 hafta olup SGA olan bebeklerin morbiditeleri ve mortalite verileri, <32 gebelik haftasında doğan gebelik haftasına uygun doğum ağırlığı ile doğan (appropriate for gestational age: AGA) bebekler ile karşılaştırıldı.Bulgular: Çalışmaya 122 (%24,6) SGA ve 372 (%75,4) AGA bebek olmak üzere toplam 494 prematüre bebek dâhil edildi. Doğumda SGA olan bebeklerde AGA olanlara göre annede preeklampsi, nekrotizan enterokolit (NEK), prematüre retinopatisi (ROP), intraventiküler kanama (İVK) oranı daha yüksekti. Ayrıca SGA olanlarda AGA olanlara göre tam enteral beslenmeye geçiş zamanı, yoğun bakımda yatış süresi anlamlı olarak daha yüksekti (p<0,05).Sonuç: Gebelik haftaları benzer olsa da SGA ve prematüre olan bebeklerde, AGA olan bebeklere göre İVK, ROP ve NEK gibi prematüre morbiditeleri daha yüksekti.
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Tsyvian, P. B., N. V. Bashmakova, O. P. Kovtun, L. V. Makarenko, and L. A. Pestryaeva. "Maternal and newborn infants amino acid concentrations in obese women born themselves with normal and small for gestational age birth weight." Journal of Developmental Origins of Health and Disease 6, no. 4 (April 30, 2015): 278–84. http://dx.doi.org/10.1017/s2040174415001117.
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This study was undertaken to compare amino acid concentrations in maternal and newborn infants’ serum in normal pregnancy and two groups of obese women who were born themselves with normal and small for gestational age (SGA) birth weight. Maternal cholesterol, lipoproteins concentrations and maternal and infants amino acid concentrations were evaluated at the time of delivery in 28 normal pregnancies, 46 obese pregnant women with normal birth weight (Ob-AGA group) and 44 obese pregnant women born themselves SGA (Ob-SGA group). Mean birth weight of newborn infants in Ob-SGA group was significantly less than in normal and Ob-AGA groups. Cholesterol and lipoproteins were significantly elevated in obese women (more prominent in Ob-SGA group). Most amino acid concentrations and fetal–maternal amino acid gradients were significantly lower in Ob-SGA group. These data suggest significant changes in placental amino acid transport/synthetic function in obese women who were born themselves SGA.
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Akhter, Zainab, Nicola Heslehurst, Dries Ceulemans, Judith Rankin, Roger Ackroyd, and Roland Devlieger. "Pregnancy after Bariatric Surgery: A Nested Case-Control Study of Risk Factors for Small for Gestational Age Babies in AURORA." Nutrients 13, no. 5 (May 17, 2021): 1699. http://dx.doi.org/10.3390/nu13051699.
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Bariatric surgery prior to pregnancy is a significant risk factor for small for gestational age (SGA) babies. This case-control study investigated differences between mothers delivering an SGA baby following bariatric surgery, compared to those delivering an appropriate for gestational age (AGA) baby. Out of 129 babies born to mothers in the AURORA cohort study, 25 were SGA (<10th percentile) and 97 were AGA (10th–90th percentile). Higher gestational weight gain (GWG) was significantly associated with decreased odds of SGA (aOR per kg 0.92, 95% CI 0.85–0.99). According to the Institute of Medicine GWG guidelines, 44% of SGA mothers had ‘inadequate’ GWG compared to 17% of AGA mothers. Nearly half of the mothers had ‘excessive’ GWG yet still gave birth to an SGA or AGA baby. Mothers of SGA babies lost more weight following bariatric surgery (45.6 ± 14.4 kg vs. 39.0 ± 17.9 kg). Women who reported receiving nutritional advice following bariatric surgery were significantly less likely to have an SGA baby (aOR 0.15, 95% CI 0.0.4–0.55). Women with a history of bariatric surgery should be provided with specialized support before and during pregnancy to encourage adequate nutritional intake and weight gain to support healthy fetal growth.
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Yamazaki, Shoko, Haruka Obinata, Akira Hachiya, Motoko Kamiya, Noriko Motoki, Tomohiko Nakamura, and Yohei Akazawa. "Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants." American Journal of Perinatology 35, no. 12 (April 24, 2018): 1178–85. http://dx.doi.org/10.1055/s-0038-1642060.
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Objective To evaluate the impact of serum insulin-like growth factor-1 (IGF-1) levels on cardiac function in small for gestational age (SGA) infants. Study Design This is a prospective, observational study. Serum IGF-1 levels at birth and echocardiography measurements at 1 week of age were compared between SGA and appropriate for gestational age (AGA) infants. Results Thirty-one SGA infants and 27 AGA infants were enrolled. Serum IGF-1 levels were lower in the SGA infants than in the AGA infants. SGA infants had lower mitral lateral annular systolic (S') and early diastolic (E') tissue Doppler imaging velocities compared with AGA infants (S', 5.1 ± 0.9 vs 5.7 ± 1.2 cm/s; E', 6.1 ± 1.5 cm/s vs 7.1 ± 1.3 cm/s; p < 0.05). Serum IGF-1 levels positively correlated with E' velocity in the entire population (r = 0.44, p < 0.001) and in SGA infants (r = 0.39, p < 0.05). In multivariate linear regression analysis, serum IGF-1 and S' velocity were independently associated with E' velocity in the entire population and in SGA infants. Conclusion Decreased serum IGF-I levels could account for cardiac diastolic dysfunction in SGA infants.
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Wang, Yingmin, Weifen Zhu, Lianhui Chen, and Li Liang. "Early Growth Hormone Intervention Improves Glucose Metabolism in Adult Rats Born Small for Gestational Age." Experimental and Clinical Endocrinology & Diabetes 128, no. 02 (September 26, 2018): 125–32. http://dx.doi.org/10.1055/a-0723-3544.
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Abstract Background Small for gestational age (SGA) due to intrauterine malnourishment is closely related to metabolic syndrome and type 2 diabetes mellitus. Growth Hormone (GH) treatment has been demonstrated to influence metabolic parameters and islet function of SGA individuals. The present study demonstrates the effects of early GH treatment on glucose tolerance and expression of pancreatic duodenal homeobox 1 (Pdx1) of SGA rats during adulthood. Methods SGA rat model was induced by restricting food intake during pregnancy. GH or normal saline was administered during postnatal days 21–35 of SGA rats and appropriate for gestational age (AGA) rats, respectively. Results In early adulthood (postnatal day 70), as compared to AGA rats, SGA rats showed: (1) decreased body weight; (2) increased postprandial blood glucose; and (3) down-regulated Pdx1 with increased histone deacetylase (HDAC) and down-regulated histone H3-lysine 4 methyltransferase SET7/9. Exogenous GH administration led to a restoration of body weight and normalized glucose tolerance due to an enhanced Pdx1 expression, accompanied by decreased HDAC and up-regulated SET7/9 in SGA rats in early adulthood. Conclusion Our results demonstrate positive effects on glucose metabolism by an early and short GH treatment in SGA adulthood.
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Chen, Sue-Jar, Chie-Pein Chen, Fang-Ju Sun, and Chen-Yu Chen. "Comparison of Placental Three-Dimensional Power Doppler Vascular Indices and Placental Volume in Pregnancies with Small for Gestational Age Neonates." Journal of Clinical Medicine 8, no. 10 (October 11, 2019): 1651. http://dx.doi.org/10.3390/jcm8101651.
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This prospective observational study aimed to compare the changes in placental vascular indices and placental volume using three-dimensional power Doppler (3DPD) ultrasound in pregnancies with small for gestational age (SGA) neonates. We enrolled 396 women with singleton pregnancies from September 2013 to June 2016. Placental vascular indices, including the vascularization index (VI), flow index (FI), and vascularization flow index (VFI), and placental volume were obtained using 3DPD ultrasound in the first and second trimesters. Of the enrolled women, 21 delivered SGA neonates and 375 did not. In the first trimester, the SGA group had a significantly lower mean FI (25.10 ± 7.51 versus 33.10 ± 10.97, p < 0.001) and VFI (4.59 ± 1.95 versus 6.28 ± 2.35, p = 0.001) than the non-SGA group. However, there was no significant difference in the placental volume between the two groups during the first trimester. In the second trimester, the SGA group also had a significantly lower mean FI (27.08 ± 7.97 versus 31.54 ± 11.01, p = 0.022) and VFI (6.68 ± 1.71 versus 8.68 ± 3.09, p < 0.001) than the non-SGA group. In addition, a significantly smaller placental volume was noted in the SGA group (104.80 ± 24.23 cm3 versus 122.67 ± 26.35 cm3, p = 0.003) than in the non-SGA group during the second trimester. The results showed that a decreased placental VFI occurred earlier than a decreased placental volume in SGA pregnancies.
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Lindström, Linda, Anna-Karin Wikström, Eva Bergman, and Maria Lundgren. "Born Small for Gestational Age and Poor School Performance – How Small Is Too Small?" Hormone Research in Paediatrics 88, no. 3-4 (2017): 215–23. http://dx.doi.org/10.1159/000477905.
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Aim: To assess the relationship between severity of small for gestational age (SGA) and the risk of poor school performance, and to investigate whether adult stature modifies this risk. Methods: 1,088,980 Swedish children born at term between 1973 and 1988 were categorized into severe SGA (less than –3 standard deviations (SD) of expected birth weight), moderate SGA (–2.01 to –3 SD), mild SGA (–1.01 to –2 SD), and appropriate for gestational age (–1 to 0.99 SD). The risk of poor school performance at the time of graduation from compulsory school (grades <10th percentile) was calculated using unconditional logistic regression models and adjusted for socio-economic factors. In a sub-analysis, we stratified boys by adult stature, and adjusted for maternal but not paternal height. Results: All SGA groups were significantly associated with an increased risk of poor school performance, with adjusted odds ratios and 95% confidence intervals ranging from 1.85 (1.65–2.07) for severe SGA to 1.25 (1.22–1.28) for mild SGA. In the sub-analysis, all birth weight groups were associated with an increased risk of poor school performance among boys with short stature compared to those with non-short stature. Conclusion: Mild SGA is associated with a significantly increased risk of poor school performance, and the risk increases with severity of SGA. Further, this risk diminishes after adequate catch-up growth.
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Gómez-Roig, M. Dolores, Edurne Mazarico, Daniela Cárdenas, M. Teresa Fernandez, Marta Díaz, Beatriz Ruiz de Gauna, Antonio Vela, Eduard Gratacós, and Francesc Figueras. "Placental 11B-Hydroxysteroid Dehydrogenase Type 2 mRNA Levels in Intrauterine Growth Restriction versus Small-for-Gestational-Age Fetuses." Fetal Diagnosis and Therapy 39, no. 2 (August 1, 2015): 147–51. http://dx.doi.org/10.1159/000437139.
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Introduction: The objective of this study was to evaluate placental 11B-hydroxysteroid dehydrogenase type 2 (11B-HSD-2) mRNA levels in intrauterine growth-restricted fetuses (IUGR) as compared with small-for-gestational-age (SGA) fetuses according to clinical criteria. Material and Methods: Placental levels of 11B-HSD-2 mRNA levels were measured in SGA (birth weight <10th centile) and gestational-age-matched, appropriate-for-gestational-age (AGA) births. SGA was classified as IUGR (birth weight <3rd centile or <10th percentile with abnormal uterine artery Doppler or cerebroplacental ratio) or non-IUGR SGA. After RNA extraction, mRNA levels were determined by reverse transcription and quantitative PCR. Results: A total of 38 placentas were analyzed (20 AGA and 18 SGA). Among the SGA pregnancies, 13 qualified as IUGR. The activity of 11B-HSD-2 in IUGR pregnancies [0.105 (SD 0.328)] was significantly reduced compared to non-IUGR SGA [0.304 (SD 0.261); p = 0.018] and AGA [0.294 (SD 0.328); p = 0.001]. These differences remained significant after adjusting for potential confounders (such as smoking or maternal cortisol levels). Activity levels did not significantly differ between non-IUGR SGA and AGA. Discussion: IUGR fetuses had reduced 11B-HSD-2 activity in comparison with SGA and normally grown fetuses. This finding provides opportunities to develop new placental biomarkers for the phenotypic characterization of fetal smallness.
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Olbertz, Dirk Manfred, Rebekka Mumm, Ursula Wittwer-Backofen, Susanne Fricke-Otto, Anke Pyper, Johannes Otte, Martin Wabitsch, et al. "Identification of growth patterns of preterm and small-for-gestational age children from birth to 4 years – do they catch up?" Journal of Perinatal Medicine 47, no. 4 (May 27, 2019): 448–54. http://dx.doi.org/10.1515/jpm-2018-0239.
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Abstract Background A legitimate indication for growth hormone (GH) therapy in children born too light or short at birth [small-for-gestational age (SGA)] exists in Germany and the European Union only if special criteria are met. Methods We conducted a longitudinal, multi-centered study on full-term appropriate-for-gestational age (AGA, n=1496) and pre-term born SGA (n=173) and full-term SGA children (n=891) in Germany from 2006 to 2010. We analyzed height, weight, body mass index (BMI) and head circumference. Results Pre-term or full-term born SGA children were shorter, lighter and had a lower BMI from birth until 3 years of age than full-term AGA children. The growth velocity of the analyzed anthropometric measurements was significantly higher in pre-term and full-term SGA children exclusively in the first 2 years of life than in AGA children. The criteria for GH treatment were fulfilled by 12.1% of pre-term SGA children compared to only 1.3% of full-term SGA children. Conclusion For children that do not catch up growth within the first 2 years of life, an earlier start of GH treatment should be considered, because a catch-up growth later than 2 years of life does not exist. Pre-term SGA-born children more frequently fulfill the criteria for GH treatment than full-term SGA children.
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Barton, Sarah Rachel, Ian Chau, Clare Peckitt, Francesco Sclafani, and David Cunningham. "Reporting of subgroup analyses (SGA) in phase III randomized trials in gastrointestinal (GI) cancer." Journal of Clinical Oncology 31, no. 4_suppl (February 1, 2013): 78. http://dx.doi.org/10.1200/jco.2013.31.4_suppl.78.
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78 Background: Correct interpretation of SGA is important as it influences selection of therapeutic interventions for patient subsets. We aimed to evaluate the association of prospectively determined study characteristics with reporting of SGA and claims of subgroup effects in GI cancer trials. Methods: We performed a systematic literature review and extracted data from all articles meeting the following criteria: published 01/01/2003-01/09/2012 in peer-reviewed journal; reporting results of phase III randomised controlled trial; n≥150; testing investigational medicinal product in GI cancer. The primary aim was to compare reporting of SGA between industry and nonindustry sponsored trials. Results: 145 trials were identified. SGA were reported in 100 (69%). A significantly larger median number of SGA were reported in industry than in non-industry sponsored trials (6 vs 2, p=0.004). In the 52 trials claiming subgroup effects, significant test of interaction was evident in only 25%, with no difference between industry and non-industry trials (Table). There was an association between larger number of trial subjects and more SGA reported (p<0.001). Trials of targeted therapy compared to cytotoxic (median 6 vs 2, p=0.004) and trials with significant primary endpoint (median 6 vs 2, p=0.006) reported more SGA. Industry sponsored trials with a significant primary endpoint reported more SGA (median 8) than others (p<0.001). Conclusions: Industry sponsored trials with positive result and trials of targeted therapy appear to report SGA more frequently. Since only quarter of trials claiming subgroup effects had evidence of significant test of interaction, circumspection should be adopted when using SGA as the basis for variance in GI cancer treatment. Conference abstracts may contain more SGA, and these will be incorporated into further analyses. [Table: see text]
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Yamashita, I., and S. Fukui. "Transcriptional control of the sporulation-specific glucoamylase gene in the yeast Saccharomyces cerevisiae." Molecular and Cellular Biology 5, no. 11 (November 1985): 3069–73. http://dx.doi.org/10.1128/mcb.5.11.3069-3073.1985.
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In the yeast Saccharomyces cerevisiae, glucoamylase activity appears specifically in sporulating cells heterozygous for the mating-type locus (MAT). We identified a sporulation-specific glucoamylase gene (SGA) and show that expression of SGA is positively regulated by the mating-type genes, both MATa1 and MAT alpha 2. Northern blot analysis revealed that control of SGA is exerted at the level of RNA production. Expression of SGA or the consequent degradation of glycogen to glucose in cells is not required for meiosis or sporulation, since MATa/MAT alpha diploid cells homozygous for an insertion mutation at SGA still formed four viable ascospores.
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Yamashita, I., and S. Fukui. "Transcriptional control of the sporulation-specific glucoamylase gene in the yeast Saccharomyces cerevisiae." Molecular and Cellular Biology 5, no. 11 (November 1985): 3069–73. http://dx.doi.org/10.1128/mcb.5.11.3069.
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In the yeast Saccharomyces cerevisiae, glucoamylase activity appears specifically in sporulating cells heterozygous for the mating-type locus (MAT). We identified a sporulation-specific glucoamylase gene (SGA) and show that expression of SGA is positively regulated by the mating-type genes, both MATa1 and MAT alpha 2. Northern blot analysis revealed that control of SGA is exerted at the level of RNA production. Expression of SGA or the consequent degradation of glycogen to glucose in cells is not required for meiosis or sporulation, since MATa/MAT alpha diploid cells homozygous for an insertion mutation at SGA still formed four viable ascospores.
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Lucas, A. "Growth of SGA babies." Acta Paediatrica 87, no. 1 (January 2, 2007): 115–16. http://dx.doi.org/10.1111/j.1651-2227.1998.tb01402.x.
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Bartels, Dorothee B. "Outcomes of SGA infants." Journal of Pediatrics 145, no. 2 (August 2004): 278–79. http://dx.doi.org/10.1016/j.jpeds.2004.03.040.
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Uçar, Ahmet, Michal Yackobovitch-Gavan, Oğuz Bülent Erol, Ensar Yekeler, Nurçin Saka, Firdevs Baş, Şükran Poyrazoğlu, Rüveyde Bundak, and Feyza Darendeliler. "Associations of Size at Birth and Postnatal Catch-up Growth Status With Clinical and Biomedical Characteristics in Prepubertal Girls With Precocious Adrenarche: Preliminary Results." Journal of Clinical Endocrinology & Metabolism 99, no. 8 (August 1, 2014): 2878–86. http://dx.doi.org/10.1210/jc.2013-3144.
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Context: The causes of polycystic ovarian syndrome (PCOS) in girls with precocious adrenarche (PA) remain unclear. Objective: Our goal was to compare the clinical, biochemical, and ultrasound characteristics of girls with PA whose size at birth was appropriate for gestational age (AGA) vs those born small for gestational age (SGA). PCOS-associated metabolic and morphological correlates were examined. Design: Glucose tolerance, ACTH stimulation, and transabdominal ultrasounds were examined in 56 AGA and 31 SGA girls with PA. Bone age and hormonal profiles were determined. SGA girls were divided into 2 groups by catch-up growth (CUG) status. Subgroups were compared. Results: Chronological age, Tanner stage for pubarche, ovarian volume, and uterine volume were similar between the groups. SGA girls had lower body mass index and higher bone age-adjusted post-corticotropin cortisol. We found increased body mass index-adjusted mean serum insulin, reduced insulin sensitivity, and reduced IGF-binding protein-1 in SGA girls. Multicystic ovaries were more common in SGA girls (odds ratio [OR] = 9.69, 95% confidence interval [CI] = 3.34–28.15; P < .001). SGA girls without CUG had a higher incidence of multicystic ovaries than CUG counterparts (OR = 8.4, 95% CI = 1.4–19.3; P = .027). Being born SGA (OR = 43.4, 95% CI = 6.9–84.7; P = .001] and exaggerated 17-hydroxyprogesterone response (OR = 15.8, 95% CI = 1.7–49.8; P = .015) were associated with multicystic ovaries. Conclusions: Significant differences in hormone levels, insulin sensitivity, and ovarian maturity were found in prepubertal girls with PA who were SGA. Longitudinal follow-up will help determine whether these factors contribute to a specific PCOS phenotype in SGA girls with PA.
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Milona, Eleni, Dimitrios Rallis, Georgios Mitsiakos, Evanthia Goutsiou, Elias Hatziioannidis, Christos Tsakalidis, Maria Lithoxopoulou, Nikolaos Nikolaidis, and Paraskevi Karagianni. "Evaluation of cerebral oxygenation and perfusion in small for gestational age neonates and neurodevelopmental outcome at 24–36 months of age." Journal of Perinatal Medicine 48, no. 3 (March 26, 2020): 280–88. http://dx.doi.org/10.1515/jpm-2019-0274.
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AbstractObjectiveTo examine cerebral oxygenation and perfusion in small for gestational age (SGA) compared with appropriate for gestational age (AGA) neonates during the first postnatal week, and to investigate any association with neurodevelopmental outcomes at 24–36 months of age.MethodsA prospective matched case-control study was conducted evaluating cerebral oxygenation and perfusion, using near-infrared spectroscopy (NIRS), between SGA and AGA neonates, during the first postnatal week. A neurodevelopmental assessment with Bayley-III was performed at 24–36 months of age.ResultsForty-eight SGA and 48 AGA neonates of similar gestation (32.8 ± 2.1 vs. 32.5 ± 1.9) were enrolled. On the first postnatal day, the cerebral oxygenation was equal between SGA and AGA neonates (71 ± 7% vs. 72 ± 8%); however, in the subgroup analysis, males had higher oxygenation compared to female SGA neonates (73 ± 7% vs. 69 ± 7%, P = 0.04). Cerebral perfusion was significantly higher in SGA neonates on the first postnatal day (1.4 ± 0.6 vs. 1.1 ± 0.5, P = 0.04), but this difference was diminished on subsequent measurements. There were no significant differences between the SGA and AGA infants regarding the composite cognitive, communication and motor index scores. The length of mechanical ventilation and late-onset sepsis were significant risk factors affecting the cognitive and communication composite index scores, respectively.ConclusionCerebral oxygenation was equal between SGA and AGA neonates, while cerebral perfusion was transiently increased in SGA neonates during the first postnatal day. There was no significant association of cerebral oxygenation and perfusion with neurodevelopmental outcomes.
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Naimi, Ashley, and Jacob Larkin. "Effect of Population-Specific Birthweight Curves on Disparities in Perinatal Mortality in Small-for-Gestational Age Pregnancies." American Journal of Perinatology 35, no. 07 (December 13, 2017): 695–702. http://dx.doi.org/10.1055/s-0037-1608791.
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Objective To determine the effect of adopting sex or race/ethnicity-specific birthweight curves on small-for-gestational age (SGA)-associated mortality rates for specific populations. Materials and Methods Analyzing 20,095,735 singleton pregnancies, we compared rates of perinatal death associated with SGA in distinct sex and racial/ethnic groups when SGA was defined using nonspecific, sex-specific, and race/ethnicity-specific birthweight curves. Results With use of a nonspecific birthweight curve, the rate of perinatal death was higher for SGA males (20.4/1,000 [95% confidence interval (CI), 20.1, 20.7]) than SGA females [14.6/1,000 (95% CI, 14.4, 14.8)]. With a sex-specific curve, this disparity was reduced, measuring 17.7/1,000 (95% CI, 17.4, 17.9) for SGA males and 16.3/1,000 (95% CI, 16.1, 16.6) for females. Using a nonspecific birthweight curve, perinatal death rates were higher for non-Hispanic blacks (20.4/1,000 [95% CI, 20.0, 20.8]) than for all other racial/ethnic groups (15.9/1,000 [95% CI, 15.7, 16.1]). This difference increased with use of a race-specific birthweight curve: perinatal mortality was 29.7/1,000 (95% CI, 29.0, 30.3) for SGA blacks and 14.7/1,000 (95% CI, 14.6, 14.9) for all other racial/ethnic groups. Conclusion Population-based differences in SGA-associated mortality are reduced with adoption of a sex-specific birthweight curve, but widen with use of a race/ethnicity-specific curve. These findings highlight the importance of outcomes analysis in the selection of diagnostic criteria for SGA.
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Mazid, Mohd, Rajib Chowdhury, and Fiza Khan. "Evaluation of Chickpea Cultiv ation Approaches in Terms of Environmental Resilience and Future Protein Security." Current Agriculture Research Journal 2, no. 2 (November 19, 2014): 102–13. http://dx.doi.org/10.12944/carj.2.2.07.
Full textAbstract:
The commercial growth in chickpea production for exportation purposes is not keeping pace with increasing demand for protein and protein derived products. In this concern, a pot experiment was conducted under field conditions during winter 2013-2014 at Botany department, AMU, Aligarh, India. Treatment consists of (1) FW (2) FP (3) FS (4) FPS (5) SGA (6) SGA+FP (7) SGA+FS (8) SGA+FPS (9) FGA (10) FGAP (11) FGAS (12) FGAPS (13) SGA+FGA (14) SGA+FGAP9 (15) SGA+FGAS (16) SGA+FGAPS. Before sowing, the seeds of chickpea are soaked for 8 h in 10-6M GA3. After 60 and 70 days of sowing, the plants were sprayed with 10-6MGA3 along with 2 kg P and /or S/ha in equal splits. Performance of the crop was assessed especially in terms of nodule number per plant, nitrate reductase activity (NR), nitrogenase (N-ase) two most significant N-fixing enzymes, leghaemoglobin content (Lb), pod weight per plant, seed yield per plant, and seed protein content. Nitrogen (N), phosphorus (P) and potassium (K) content in leaves were influenced almost non-significantly due to applied P and S level. Treatment (16) SGA+FGAPS proved best, it enhanced NR by 22.37% and 22.46%; Lb by 206.113 and 215.38% respectively at 90 and 100 DAS. Seed yield per plant and seed protein content enhanced by 86 and 21% by the same treatment at harvest without compromising the N-fixing activity.