Obstetrics: Normal and Problem Pregnancies. Philadelphia, PA: Elsevier; chap 9. Updated by: Neil K. Editorial team. Appropriate for gestational age AGA. Gestational age can be determined before or after birth. Before birth, your health care provider will use ultrasound to measure the size of the baby's head, abdomen, and thigh bone. This provides a view on how well the baby is growing in the womb.
After birth, gestational age can be measured by looking at the baby. Weight, length, head circumference, vital signs, reflexes, muscle tone, posture, and the status of the skin and hair are assessed. Although the discharge database was initially developed as a tool for assessing funding related to medical activities in public and private hospitals, the main variables used in this study were recently found to be robust when compared with national vital statistics data [ 13 ] and to a national perinatal survey [ 10 ].
Furthermore, reporting of the variables in our study length of stay, intensive care utilisation, birth weight, gestational age, mortality are legally binding on hospitals and subject to controls. The main limitation was that our study considered only hospital costs. Moreover, the 1-year time horizon is too short to fully capture the economic consequences of SGA birth. The long term health impacts have been documented, and their costs will be assessed in future cohort studies. Other studies of preterm infants compared to full term infants found both higher mortality and complication rates [ 17 ], higher service utilisation and costs [ 4 , 8 ] and an inverse relationship between gestational age and costs [ 6 — 8 , 16 ].
The total costs of preterm infants in our study are comparable to those reported in countries with developed neonatal intensive care units [ 3 , 4 , 8 , 9 ]. Thus costs in the 22—28 weeks gestational age group may be even higher in countries were full resuscitation is standard care. This cost difference is higher than in our study but used a different costing methodology.
The most recently published cost study of preterm infants in the East Midlands reports birth to discharge hospital costs comparable to ours, with the same association between costs and gestational age [ 6 ]. We found that being SGA predicted high hospital costs regardless of gestational age. The additional cost of SGA births was explained by higher complication rates, more frequent hospital readmissions and longer lengths of stay.
SGA appears to be an independent contributor to high hospital costs in the short term. This data could be used in models to predict the costs associated with SGA [ 19 ]. AM and AFP performed the data analysis, interpreted the results and drafted the manuscript.
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IDZ and DEB contributed to the study design; data analysis and interpretation reviewed and revised the manuscript. All authors read and approved the final version. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Antoine Filipovic-Pierucci, Email: rf.
Olivier Baud, Email: rf. Vassilis Tsatsaris, Email: rf. Anne Ego, Email: rf. Marie-Aline Charles, Email: rf.
Small-for-Gestational-Age (SGA) Newborn - Children's Health Issues - MSD Manual Consumer Version
Isabelle Durand-Zaleski, Email: rf. National Center for Biotechnology Information , U. Published online Mar Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Aug 25; Accepted Mar This article has been cited by other articles in PMC.
Abstract Background Small for gestational age SGA infants are at increased risk for preterm birth morbidities as well as a range of adverse perinatal outcomes that result in part from associated premature birth. Methods This is a cross-sectional population-based study using national hospital discharge data from French public and private hospitals. Results Of , total births in , 84, SGA births Conclusions Being small for gestational age is an independent contributor to 1-year hospital costs for both mothers and infants. Keywords: Small for gestational age, Database, Economic cost, Prematurity.
Background Small for gestational age SGA infants are defined by a birth weight lower than the 10th percentile for a given gestational age. Population We extracted the records of all infants born in metropolitan France in public and private hospitals from January 1, to December 31, Outcomes Type of delivery and complications were identified by the International Classification of Diseases, tenth revision ICD and procedures codes. Hospital resources and costs A summary of all hospital inpatient service utilisation from the day of birth through the first year of life was compiled for all study infants.
Open in a separate window. Table 1 Characteristics of the population at birth in small and average for gestational age infants, and risk ratios between groups. Outcomes Caesarean section delivery was performed for Hospital resources and costs Mothers Hospital admission during the prenatal period occurred in Infants The 84, SGA births had 1.
Discussion Main findings While there is published evidence on the economic consequences of preterm birth in several countries, the impact of being small for gestational age has seldom been assessed. Strength and limitations The strength of our study lies in the fact that we have an exhaustive French hospital database with record linkage over a 2-year period. Interpretation Other studies of preterm infants compared to full term infants found both higher mortality and complication rates [ 17 ], higher service utilisation and costs [ 4 , 8 ] and an inverse relationship between gestational age and costs [ 6 — 8 , 16 ].
Conclusion We found that being SGA predicted high hospital costs regardless of gestational age. Competing interests The authors declare that they have no competing interests. Consent for publication Not applicable. Ethics approval and consent to participate Not applicable. We thank Ms Tingting Li and Ms Honghua Liu for their help with data collection; these individuals have no conflict of interest related to the subject matter. We thank colleagues from the Department of Statistics at Fudan University for creating cartograms.
We thank colleagues from Cornell University for correcting the English language in the manuscript.
National Center for Biotechnology Information , U. J Int Med Res. Published online Jul Author information Article notes Copyright and License information Disclaimer.
Email: moc. Email: nc. Received Nov 10; Accepted May 2. This article has been cited by other articles in PMC. Short abstract 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.
Keywords: Small for gestational age, growth restriction, overweight, obesity, catch-up growth, growth chart. Material and methods Study design and sampling procedure This study was part of a large, community-based, general social survey on growth and development in children aged younger than 6 years old in Shanghai. Measures and procedure Data on growth during the first 6 years after birth were retrospectively obtained from medical records kept at maternal and child health institutions and nurseries during a 6-month period between September and March Statistical analysis We first assessed the median growth and variability in growth for weight, height, and HC from birth to 60 months, per month of age and by sex.
Results Background characteristics Our study group consisted of , children born in Shanghai of whom 23, were born SGA.
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- Appropriate for gestational age (AGA);
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- Small for Gestational Age.
SGA occurred more often in girls than in boys Table 1 Table 1. Characteristic Total Boys Girls Total Open in a separate window. Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Correlations between overweight at different ages Correlations between overweight at 5 years old and overweight at other ages are shown in Table 2.
go Table 2. Correlations between overweight at 5 years old and overweight at other ages. SGA, small for gestational age. Discussion In this population-based study of children who were born SGA, we showed persistent associations of birth weight with growth status in infancy and early childhood to 60 months of age. Figure 7. Figure 8. Figure 9. Acknowledgements We thank Ms Tingting Li and Ms Honghua Liu for their help with data collection; these individuals have no conflict of interest related to the subject matter.
Declaration of conflicting interests The authors declare that there is no conflict of interest. References 1. Mortality and morbidity in preterm small-for-gestational-age infants: a population-based study. Am J Obstet Gynecol ; : Mode of delivery and neonatal outcomes in preterm, small-for-gestational-age newborns. Obstet Gynecol ; : — Gillman MW.
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N Engl J Med ; : Consequences of intrauterine growth and early neonatal catch-up growth. Semin Perinatol ; 34 : — Insulin resistance and adiponectin levels are associated with height catch-up growth in pre-pubertal Chinese individuals born small for gestational age.
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