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(SGA)

Small for Gestational Age (SGA)

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What are SGA babies?

Introduction

Normal babies usually weigh about 2.5 kg to 3.5 kg.

Small for gestational age (SGA) babies are much smaller
than normal babies of the same gestation.

Definition

Small for gestational age babies :

Birth weight less than 10th percentile for their

gestational age (number of weeks of pregnancy).

These babies weigh less and are smaller than 90% of

all other babies of the same gestation.

Babies whose weight fall in the area below the 10%

line in the intrauterine growth chart – refer to
diagram.

What are the types of SGA babies?

SGA Babies:

May be term or preterm.

Term infants usually weigh less than 2.5 kg.

Types of SGA :

Symmetrical – proportionately small all over.

Asymmetrical – the head is proportionately larger

compared to rest of body.

What are the causes of SGA babies?

Causes:

Genetics

small parents may produce small babies

some chromosomal abnormalities in babies may

cause them to be small

Intrauterine growth retardation (IUGR).

What is intrauterine growth retardation

(IUGR)?

Intrauterine growth retardation (IUGR) occurs when a

baby’s growth in the womb is restricted due to shortage
of oxygen and nutrients that are needed for proper
growth. Therefore factors affecting blood flow to the
baby in the womb can lead to IUGR because decreased
blood flow will lead to reduced delivery of oxygen and
nutrients to tissue and organs.

What are the risk factors for IUGR?

Risk factors in :

Mother

Very young mothers or elderly mothers

High blood pressure

Uncontrolled long standing diabetes

Chronic kidney disease

Infections

Severe anemia

Smoking / alcohol / illicit drugs

Pregnancy

1. Multiple pregnancy (twins, triplets)

2. Placenta abruption (placenta separates from womb

before time)

3. Placenta previa (placenta lies low in the womb and

may bleed)

4. Poor placental blood flow

5. Infections in the tissues surrounding the placenta or

uterus

Fetal

Birth detect – brain, heart / kidney

Infection eg. Rubella

Chromosome anomaly eg Tnsomy18

What are the features of an SGA baby?

Term SGA babies look mature like a normal babies

except that they are smaller in size.

What problems would an SGA baby have?

Early complications

Hypoglycaemia (low blood sugar)

Polycythaemia (too many red blood cells)

Hypothermia (cannot maintain body heat)

Breathing difficulties

Jaundice

Electrolyte imbalance

Late complications

Dependant on cause of SGA, for example; a baby

with chromosomal abnormality like Edward’s
Syndrome has a poor outcome with a high risk of
mortality within first few days or weeks of life.

Catch-up growth may occur in some babies while

others remain small throughout childhood.

SGA babies have been associated with a higher risk of

adult onset chronic diseases like hypertension,
diabetes and heart diseases.

How should SGA babies be managed?

Specific treatment is based on the baby’s condition and

needs but most of these babies would need

Monitoring of blood glucose

Early and frequent feeding

Some babies may require admission to the neonatal

ward for :

Tube feeding, high caloric feeding

Intravenous fluids / dextrose (fluids given into the

veins)

Respiratory support

Blood exchange

Phototherapy for jaundice

What can be done to prevent babies from

becoming SGA?

Antenatal care during pregnancy is very important to :

Monitor mother’s health

Manage any maternal illness – example high blood

pressure

Monitor growth of fetus

Check for any placental abnormalities

Check for fetal abnormalities

Plan a safe delivery

Expectant mothers should:

Avoid harmful substances such as drugs, alcohol and

smoking.

Eat a healthy diet.

Last reviewed : 28 August 2020

Content Writer : Dato’ Dr. Lim Nyok Ling

Dr. Lim Sern Chin

Reviewer : Dr. Zainab bt. Kusiar

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Last Update
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