small for gestational age

• A newborn who weighs less than 90% of newborns of the same gestational age at birth (below the 10th percentile) is considered small for gestational age.
• SGA infants are small for their age because they have experienced intrauterine growth restriction (IUGR) or failed to grow at the expected rate in utero
• SGA babies may be premature, full-term , or post-term
• Growth restrictions can be classified as:

  symmetric and asymmetric
• The newborn is proportionately small, that is, its weight, length, and head size are similarly low or small.

  Symmetric
• Weight, length, or head size are not equally affected (for example, head size may continue to grow as expected, but weight or length may be lower than expected).

  Asymmetric
• In symmetric growth restriction, the cause probably occurred early in the pregnancy when it would affect all of the cells in the newborn's body
• Asymmetric growth restriction probably results from problems that occur later in pregnancy because some tissues develop sooner than others and not all would be affected equally.
• Many babies with SGA have a condition called intrauterine growth restriction (IUGR).
• IUGR occurs when the fetus does not receive the necessary nutrients and oxygen needed for proper growth and development of organs and tissues.
• Early-onset IUGR is often due to chromosomal abnormalities, maternal disease, or severe problems with the placenta.
• Late-onset growth restriction (after 32 weeks) is usually related to other problems.
• Signs and Symptoms of Small for Gestational Age

  • Birth Asphyxia
  • Meconium Aspiration
  • hypoglycemia
  • polycythemia
• Treatment for Small for Gestational Age

  no specific treatment for small-for gestational-age newborns
• Growth hormone injections are sometimes given to certain SGA infants who remain small at 2 to 4 years of age.
• how many bones are there in a newborn

  300
• Newborns with polycythemia are given ?

  IV fluids
• Newborns with hypoglycemia are treated with?

  IV Glucose within 1 hr of birth
• Nursing Interventions for Small for Gestational Age

  • Monitoring of oxygen levels
  • assessment of the newborn's respiratory status
  • Monitoring of the newborn's glucose status
  • temperature controlled beds