胎児発育遅延の、超低出生体重の

WordNet

an infant whose size and weight are considerably less than the average for babies of the same age (同)SGA_infant
slight or limited; especially in degree or intensity or scope; "a series of death struggles with small time in between"
a garment size for a small person
the slender part of the back
limited or below average in number or quantity or magnitude or extent; "a little dining room"; "a little house"; "a small car"; "a little (or small) group" (同)little
have fine or very small constituent particles; "a small misty rain"
on a small scale; "think small"
people who are old collectively; "special arrangements were available for the aged" (同)elderly
at an advanced stage of erosion (pronounced as one syllable); "aged rocks"
(used of tobacco) aging as a preservative process (`aged is pronounced as one syllable) (同)cured
advanced in years; (`aged is pronounced as two syllables); "aged members of the society"; "elderly residents could remember the construction of the first skyscraper"; "senior citizen" (同)elderly, older, senior
having attained a specific age; (`aged is pronounced as one syllable); "aged ten"; "ten years of age" (同)of age
of wines, fruit, cheeses; having reached a desired or final condition; (`aged pronounced as one syllable); "mature well-aged cheeses" (同)ripened
how long something has existed; "it was replaced because of its age"
a time of life (usually defined in years) at which some particular qualification or power arises; "she was now of school age"; "tall for his eld" (同)eld
begin to seem older; get older; "The death of his wife caused him to age fast"
make older; "The death of his child aged him tremendously"
the organic process of growing older and showing the effects of increasing age (同)ageing, senescence
growing old (同)ageing, senescent

PrepTutorEJDIC

(大きさが)『小さい』,小形の;(量が)『少ない』,わずかな / 『取るに足りない』,ささいな(trivial) / 《名詞の前にのみ用いて》(仕事・活動などが)『小規模の』,ささやかな / 心が狭い,利己的な / (音・声が)弱い,小さい / (文字が)小型の,小文字の / 《the~》小さいもの;(…の)細い部分《+『of』+『名』》 / 《複数形で》《英》(衣類・ハンカチなどの)小物,小間物 / 小さく,細かく / (声などが)低く,弱く / 小規模に,こぢんまりと
《補語にのみ用い,数詞を伴って》…『歳の』 / (酒・チーズなどが)熟成した
年とった
《時間・距離》『…の間』 / 《利益・貢献》『…のために』 / 《適応・用途》『…向きの(に);』…用の(に);…のための(に) / 《目的・意向》『…のために,』に / 《敬意・記念》『…のために;』…を記念して / 《獲得・追求》『…を得るために』,を求めて / 《行く先・方向》『…あてに;』…[方面]行きの,に向けて / 《交換・報償など》『…に対して』;…と引き換えに;…のお返しに / 《原因・理由》『…のために』,なので / 《代理・代表》『…の代わりに;』…を代表して / 《形容詞の後に用いて》『…にとって,』には / 《比較級の後に用いて》『…の結果として,』…のために / 《対比》『…としては,』のわりには / 《関連》『…について,』の点では / 《資格・属性》『…として』 / 《賛成・支持》…『に賛成して』,を支持して / 《傾向・好み》…『に対する』,には / 《模倣》《おもに米》《英文》…の名を取って(after) / 《割合》…に対して / 《『for』+『名』〈人〉+『to』 doの形で,〈人〉が不定詞to doの意味上の主語を表して》…が(…することは,…するために) / […というのは]…だから
〈U〉(一般に)『年齢』,寿命;〈C〉(個々の)『年齢』,年 / 〈U〉成年(おとなとしての資格・権利を得る年齢;通例18または21歳) / 〈U〉『老齢』;《集合的に》老人たち / 〈U〉(人生の)『一時期』;〈C〉世代(generation) / 〈U〉〈C〉《しばしばA-》(歴史上の)『時代』 / 〈C〉《話》長い間 / 年をとる,ふける;〈物が〉古くなる / 〈年〉'を'とらせる;〈物〉'を'古びさせる
年をとること / (ワイン・チーズなどの)熟成

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/09/07 21:43:39」(JST)

wiki en

Small for gestational age (SGA) newborns are those who are smaller in size than normal for the gestational age, most commonly defined as a weight below the 10th percentile for the gestational age.^[1]

Terminology

Not all newborns that are SGA are pathologically growth restricted and, in fact, may be constitutionally small. If small for gestational age babies have been the subject of intrauterine growth restriction (IUGR), formerly known as intrauterine growth retardation,^[2] the term SGA associated with IUGR is used. Intrauterine growth restriction (IUGR) refers to a condition in which a fetus is unable to achieve its genetically determined potential size. This functional definition seeks to identify a population of fetuses at risk for modifiable but otherwise poor outcomes. This definition intentionally excludes fetuses that are small for gestational age (SGA) but are not pathologically small.^[3] Infants born SGA with severe short stature (or severe SGA) are defined as having a length less than 2.5 standard deviation scores below the mean.^[4]

A related term is low birth weight (LBW), defined as an infant with a birth weight (that is, mass at the time of birth^[5]) of less than 2500 g (5 lb 8 oz), regardless of gestational age at the time of birth. Related definitions include very low birth weight (VLBW) which is less than 1500 g, and extremely low birth weight (ELBW) which is less than 1000 g.^[6] Normal Weight at term delivery is 2500 g - 4200 g.

SGA is not a synonym of LBW, VLBW or ELBW. Example: 35-week gestational age delivery, 2250g weight is appropriate for gestational age but is still LBW. One third of low-birth-weight neonates - infants weighing less than 2500g - are small for gestational age.

There is an 8.1% incidence of low birth weight in developed countries, and 6–30% in developing countries. Much of this can be attributed to the health of the mother during pregnancy. One third of babies born with a low birth weight are also small for gestational age. Infants that are born at low birth weights are at risk of developing neonatal infection.

Both low and high maternal serum Vitamin D (25-OH) are associated with higher incidence SGA in white women, although the correlation does not seem to hold for African American women.^[7]

Diagnosis

The condition is determined by birth weight and/or length.

A related condition, IUGR, is generally diagnosed by measuring the mother's uterus, with the fundal height being less than it should be for that stage of the pregnancy. If it is suspected, the mother will usually be sent for an ultrasound to confirm.

Causes

Being small for gestational age is broadly either:^[3]

Being constitutionally small, wherein the state is basically a genetic trait of the baby.
Intrauterine growth restriction, also called "pathological SGA"

Management

90 percent of babies born SGA catch up in growth by the age of 2. However, all SGA babies should be watched for signs of Failure-to-Thrive (FTT), hypoglycemia and other conditions common to SGA babies (see below). Hypoglycemia is common in asymmetrical SGA babies because their larger brains burn calories at a faster rate than their usually limited fat stores hold. Hypoglycemia is treated by frequent feedings and/or additions of cornstarch-based products (such as Duocal powder) to the feedings.

For the 10 percent of those that are SGA without catchup growth by the age of 2, an endocrinologist should be consulted. Some cases warrant growth hormone therapy (GHT).

There are some common conditions and disorders found in many that are SGA (and especially those that are SGA without catchup growth by age 2). They should be treated by the appropriate specialist:

Gastroenterologist - for gastrointestinal issues such as: reflux (GERD) and/or delayed gastric emptying (DGE)
Dietitian - to address caloric deficits. Dietitians are usually brought in for cases that include FTT. Also, according to the theory of thrifty phenotype, causes of growth restriction also trigger epigenetic responses in the fetus that are otherwise activated in times of chronic food shortage. If the offspring actually develops in an environment rich in food it may be more prone to metabolic disorders, such as obesity and type II diabetes.^[8]
Speech Language Pathologist (SLP) or Occupational Therapist (OT) - for feeding issues. OTs may also treat sensory issues
Behaviorist - for feeding issues, a behavioral approach may also be used, but usually for older children (over 2)
Allergist - to diagnose or rule out food allergies (not necessarily more common in those SGA than the normal population)
Ear, Nose and Throat doctor (ENT) - to diagnose enlarged adenoids or tonsils (not necessarily more common in those SGA than the normal population)

For IUGR (during pregnancy), possible treatments include the early induction of labor, though this is only done if the condition has been diagnosed and seen as a risk to the health of the fetus.

References

^ Small for gestational age (SGA) at MedlinePlus. Update Date: 8/4/2009. Updated by: Linda J. Vorvick. Also reviewed by David Zieve.
^ "eMedicine - Intrauterine Growth Retardation : Article by Vikram S Dogra, MD". Retrieved 2007-11-28.
^ ^a ^b "eMedicine - Fetal Growth Restriction : Article by Michael G Ross, MD, MPH". Retrieved 2010-02-25.
^ Clayton, PE; Cianfarani, S; Czernichow, P; Johannsson, G; Rapaport, R; Rogol, A (March 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.". The Journal of Clinical Endocrinology and Metabolism. 92 (3): 804–10. PMID 17200164. doi:10.1210/jc.2006-2017.
^ Definitions from Georgia Department of Public Health. Date: 12/04/2008. Original citation: "Birthweight: Infant's weight recorded at the time of birth"
^ "eMedicine - Extremely Low Birth Weight Infant : Article by KN Siva Subramanian, MD". Retrieved 2007-11-28.
^ "Bodnar LM, Catov JM, Zmuda JM, Cooper ME, Parrott MS, Roberts JM, Marazita ML, Simhan HN. Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational age births in white women. J Nutr. 2010 May;140(5):999-1006." (PDF).
^ Barker, D. J. P., ed. (1992). Fetal and infant origins of adult disease. London: British Medical Journal. ISBN 0-7279-0743-3.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 妊娠期間に比して小さい新生児 small for gestational age infant
2. 妊娠月齢に比して小さい小児に対する成長ホルモン治療 growth hormone treatment for children born small for gestational age
3. 胎児の発育遅延：評価およびマネージメント fetal growth restriction evaluation and management
4. 心血管疾患の危険因子の概要 overview of the possible risk factors for cardiovascular disease
5. 胎児発育遅延：診断 fetal growth restriction diagnosis

English Journal

A stochastic model for early placental development.

Cotter SL1, Klika V2, Kimpton L3, Collins S4, Heazell AE5.
Journal of the Royal Society, Interface / the Royal Society.J R Soc Interface.2014 Aug 6;11(97):20140149. doi: 10.1098/rsif.2014.0149.
In the human, placental structure is closely related to placental function and consequent pregnancy outcome. Studies have noted abnormal placental shape in small-for-gestational-age infants which extends to increased lifetime risk of cardiovascular disease. The origins and determinants of placental
PMID 24850904

Genome-wide screening of copy number variants in children born small for gestational age reveals several candidate genes involved in growth pathways.

Canton AP1, Costa SS1, Rodrigues TC1, Bertola DR2, Malaquias AC1, Correa FA1, Arnhold IJ1, Rosenberg C1, Jorge AA3.
European journal of endocrinology / European Federation of Endocrine Societies.Eur J Endocrinol.2014 Aug;171(2):253-62. doi: 10.1530/EJE-14-0232. Epub 2014 May 30.
BACKGROUND: The etiology of prenatal-onset short stature with postnatal persistence is heterogeneous. Submicroscopic chromosomal imbalances, known as copy number variants (CNVs), may play a role in growth disorders.OBJECTIVE: To analyze the CNVs present in a group of patients born small for gestatio
PMID 24878679

The role of depressive symptoms in the pathway of demographic and psychosocial risks to preterm birth and small for gestational age.

Quispel C1, Bangma M2, Kazemier BM3, Steegers EA4, Hoogendijk WJ5, Papatsonis DN6, Paarlberg KM7, Lambregtse-Van Den Berg MP8, Bonsel GJ9.
Midwifery.Midwifery.2014 Aug;30(8):919-25. doi: 10.1016/j.midw.2014.03.008. Epub 2014 Mar 19.
OBJECTIVE: depressive symptoms during pregnancy are associated with preterm birth (PTB) and small for gestational age (SGA). Depressive symptoms and PTB and SGA, however, share similar demographic and psychosocial risk factors. Therefore, we investigated whether depressive symptomatology is an indep
PMID 24742634

Japanese Journal

胎児期の母の受動喫煙と児の出生体重に関する最近の研究動向

小林澄貴,荒木敦子,佐々木成子,池野多美子,宮下ちひろ,伊藤佐智子,岸玲子
北海道公衆衛生学雑誌 28(2), 37-48, 2015-03
… 妊娠初期後半以降における母の受動喫煙が出生体重を減少させ、低出生体重やSGA(Small-for-gestational-age)のリスクを2倍まで上げることがわかった。 …
NAID 120005600756

Low Serum Levels of ABCA1, an ATP-Binding Cassette Transporter, Are Predictive of Preeclampsia

, , ,
The Tohoku Journal of Experimental Medicine 236(2), 89-95, 2015
… To test this hypothesis, we measured serum ABCA1 levels in 50 normal pregnancies, 36 preeclamptic pregnancies, and 24 small-for-gestational-age (SGA) pregnancies during three trimesters. … Moreover, the preeclamptic pregnancy was diagnosed with high sensitivity from the nulliparous pregnancies if the cutoff value for serum ABCA1 was 0.06 ng/ml. …
NAID 130005071004

Onset of puberty and near adult height in short children born small for gestational age and treated with GH: Interim analysis of up to 10 years of treatment in Japan

, , , , , , ,
Clinical Pediatric Endocrinology 24(2), 67-67, 2015
Vol. 24, No. 1 (2015), p. 19Fig. 3 should have been as follows:
NAID 130005069652

Related Pictures

★リンクテーブル★

リンク元	「胎児発育遅延」「fetal growth retardation」「SGA infants」「超低出生体重」
関連記事	「aging」「gestation」「AGE」「age」「aged」

「胎児発育遅延」

Small for gestational age
	Graph showing which babies fit the definition of small. (DiseaseDB #31952)
Classification and external resources
Specialty	pediatrics
ICD-10	P05, P07
ICD-9-CM	764, 765
MeSH	D007230
	[edit on Wikidata]