Longitudinal growth dynamics of term symmetric and asymmetric small for gestational age infants

Abstract

Background: Available information on auxological attainments of symmetric and asymmetric SGA (small for gestational age) infants presents conflicting views. The complete absence of longitudinal data on growth patterns of both types of Indian SGA infants prompted us to undertake this study. Aim: To study distance and velocity growth pattern of weight and crown-heel length (CHL) of symmetric and asymmetric SGA infants. Subjects & Methods: Weight and CHL amongst full-term 100 symmetric SGA, 100 asymmetric SGA and 100 AGA infants from upper socio-economic strata were mixed-longitudinally measured at birth, 1, 3, 6, 9 and 12 months in the Department of Pediatrics, PGIMER, Chandigarh, India. Results: The symmetric SGA infants measured significantly lighter and shorter than asymmetric infants. SGA infants of both types and sexes possessed significantly (p ≤ 0.001) lower weight and length values than AGA, normal Indian and western infants. Weight and CHL growth velocities demonstrated inconsistent trends. Peak growth velocity for weight and CHL of symmetric, asymmetric SGA and AGA infants was attained between 1-3 months. Average z-scores for weight and CHL were found to be lesser amongst symmetric SGA as compared to asymmetric infants, revealing compromised catch-up growth. Conclusion: The poorer postnatal auxological attainments of SGA infants as compared to normal infants reveals continuation of effect of intra-uterine nutritional insult during infancy, which measured significantly more in symmetric than asymmetric SGA infants.