Historical Perspectives

Abstract

This month’s contribution by Dr. Battaglia draws attention to the importance of both birthweight and gestational age in determining neonatal morbidity and mortality. It is hard to imagine the language of neonatology without the terms SGA, AGA, and LGA (small, appropriate, and large for gestational age), but prior to 1967 it was unusual to combine birthweight with gestational age. As Dr. Battaglia points out, small babies were considered to have been born prematurely. It is also interesting to note the mortality statistics in that era. The figures in the original article from Colorado subsequently were revised in a chart that detailed birthweight/gestational age categories by 250 g/1 week groups. (1) 1. ↵ Lubchenco LO, Searle DJ, Brazie JF. Neonatal mortality rate: relationship to birth weight and gestational age. J Pediatr. 1972;81:814–822 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] # Classification by Birthweight and Gestational Age {#article-title-2} Small for gestational age (SGA), a term that has become widely used and occasionally misused, originated in the 1960s. At that time, neonatal intensive care units (ICUs) were called “premature nurseries” because it was assumed that all babies admitted to those units were preterm infants. Consideration of the small baby born at term or even postterm had led to the use of the term “placental insufficiency syndrome,” but scant attention had been paid to the heterogeneous population that was cared for in “premature nurseries” at that time. Some years earlier, my colleagues and I at Johns Hopkins, Dr Hellegers and Dr Frazier, had published an article examining the outcome of teenage pregnancies. (1) That study alerted us to the fact that clinical problems could be missed with specific study restrictions. For example, if teenage pregnancies included 16- to 19-year-old women, the perinatal mortality rate was not increased compared with women ages 20 to 29 years. Pregnancies in the 16- to 19-year-old group were far more frequent than in girls younger than 15 years of age and masked the high perinatal mortality rate of the latter group. This prompted us … [1]: {openurl}?query=rft.jtitle%253DThe%2BJournal%2Bof%2Bpediatrics%26rft.stitle%253DJ%2BPediatr%26rft.aulast%253DLubchenco%26rft.auinit1%253DL.%2BO.%26rft.volume%253D81%26rft.issue%253D4%26rft.spage%253D814%26rft.epage%253D822%26rft.atitle%253DNeonatal%2Bmortality%2Brate%253A%2Brelationship%2Bto%2Bbirth%2Bweight%2Band%2Bgestational%2Bage.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0022-3476%252872%252980114-8%26rft_id%253Dinfo%253Apmid%252F5074362%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/S0022-3476(72)80114-8&link_type=DOI [3]: /lookup/external-ref?access_num=5074362&link_type=MED&atom=%2Fneoreviews%2F4%2F4%2Fe91.atom [4]: /lookup/external-ref?access_num=A1972N589700027&link_type=ISI