Small for Gestational Age

Definition

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

Newborn

IMAGE

Copyright © Nucleus Medical Media, Inc.

Causes

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

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

Problems with the supply of nutrients and oxygen to the baby or a small uterus

Exposure to toxic substances or certain medications

Infections or chronic illness during pregnancy

Birth defects

Genetic syndromes

Risk Factors

Parents with small stature or prior birth of a SGA baby increase the risk of SGA.

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

High blood pressure

Smoking

Substance abuse

Excessive use of alcohol

Problems with the placenta, such as placental abruption or placenta previa

Not taking folic acid supplements during pregnancy

Chronic medical conditions, such as kidney failure , gestational diabetes , asthma , systemic lupus
erythematosus , celiac disease , or anemia

Previous bariatric surgery

Certain medications

Certain infections

Malnutrition

Silver-Russell syndrome

Obstructive sleep apnea

Other factors that can affect baby’s growth include:

Pregnancy with more than 1 child

Birth defects

Genetic syndromes in the baby

Symptoms

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

Diagnosis

A baby with SGA is often diagnosed before birth based on measurements taken of the mother’s
abdomen, the mother’s weight, and size of the uterus (womb). If the measurement is low for the
number of weeks of pregnancy, then the baby may be smaller than average. SGA may also be diagnosed
at birth based on the baby’s weight and height.

Images may be taken during pregnancy with an ultrasound.

Treatment

Talk with your doctor about the best treatment plan for your baby. A baby with SGA is at higher risk for
problems, such as difficulty feeding, blood sugar abnormalities, and breathing problems. Your baby’s
health and development will be monitored closely.
Babies that have SGA due to lack of nutrition or oxygen may need treatment. Options include:

Before Delivery

Before your baby is born, the doctor may:

Monitor your baby’s growth progress closely

Deliver your baby early if the uterus is too small to allow your child to develop or there are problems
with the mother’s health or the placenta that are affecting the babies growth

Treat or try to improve the treatment of any conditions that you have

After Delivery

Babies who are born with SGA may be weak and unable to feed properly or stay warm. Treatment may
include:

Using warming beds or incubators

Providing tube feedings

Monitoring oxygen levels

Ongoing monitoring and treatment may be needed during childhood.

Prevention

SGA due to family traits, syndromes, and uterine abnormalities cannot be prevented.

If you are thinking of becoming pregnant, taking a supplement containing folic acid may reduce the risk
of having a small for gestational age baby.

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

If you smoke, talk to your doctor about ways to quit.

If you use drugs or alcohol, ask your doctor to refer you to a treatment program that will help you stop.

Start prenatal care early and continue throughout pregnancy.

Keep any chronic condition under good control.