PubMed · 8445964
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P Uvebrant. 1993-03-03. [How small is too small?].. https://pubmed.ncbi.nlm.nih.gov/8445964/
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With the aim of collecting evidence on repetition of low birth weight, intra-uterine growth retardation (IUGR), and prematurity in successive pregnancies, a systematic review was conducted on MEDLINE, LILACS, PAHO, and MedCarib from 1965 to 2004, using as descriptors: "low birth weight and recurrence, repetition or previous", "risk factors and repetition, recurrence or previous LBW", "IUGR and recurrence, repetition or previous", "risk factors and repetition, recurrence or previous IUGR", "prematurity and recurrence, repetition or previous", and "risk factors and repetition, recurrence or previous prematurity". Of 24 studies, 18 were excluded due to inconsistency between the title and the actual subject investigated (obstetric history as a risk factor rather than a selection criterion). The most important risk factors associated with repetition of low birth weight were maternal age > 30 years, smoking, short inter-gestational interval, and black skin color; those associated with IUGR were maternal age < 20 or > 35 years, low maternal education, high blood pressure, drug addiction, and non-technical/non-professional paternal occupation; and with preterm birth, premature rupture of membranes, chorioamnionitis, preeclampsia, preterm labor, and inter-gestational interval less than 12 months.
UNLABELLED: The terms "small for gestational age" and "intrauterine growth restriction" have been used interchangeably to denote an in utero growth-restricted neonate. However, the two terms are not synonymous; not all small babies are growth restricted and not all growth-restricted ones are small. Research evidence, extending back to the middle of the last century, reveals that the number of growth-restricted babies who escape attention is not negligible and that the postnatal outcome of these babies is not uneventful. This paper highlights this issue and further discusses the available diagnostic tools for the identification of in utero-restricted neonates, that is, clinical assessment, anthropometric indices and obstetric ultrasound. Each of these tools has strengths and limitations, but, if combined, each could complement the other and help differentiate well-grown babies from those who are growth restricted. CONCLUSION: Identification of growth-restricted neonates is feasible through the integrated use of diagnostic tools.
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