Clayton PE et al. (2007) Management of the child born small for gestational age through to adulthood: a consensus statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society. J Clin Endocrinol Metab 92: 804–810

Children born small for gestational age (SGA) face increased risks of perinatal death and health problems later in life. An international group of experts have formulated a consensus statement on the key health problems commonly experienced by SGA children that discusses their appropriate management.

Their recommendations state that diagnosis of SGA should be based on the child's weight, length and head circumference at birth, with the cut-off value determined as a birth weight and/or length 2 SD below the relevant population mean. Health problems shown to be associated with SGA included an increased risk of perinatal morbidity, moderate cognitive impairment, persistent short stature, metabolic alterations (including glucose intolerance and type 2 diabetes) in adulthood, and cardiovascular disease. Women born SGA are also at increased risk of pre-eclampsia, gestational diabetes, and of having an SGA child.

For all children born SGA, the authors recommend anthropometric measurements every 3 months during their first year and every 6 months thereafter, early neurodevelopmental assessment, and exclusive breast-feeding for ≥24 weeks. For SGA children with severe growth retardation (i.e. with no catch-up growth by 2–4 years of age and a height ≥2.5 SD below the population mean), growth hormone therapy is recommended until adolescence, under regular surveillance. For adults born SGA the authors found no evidence of benefit for any specific health surveillance or lifestyle interventions.