[Short-term outcome and small for gestational age newborn management]

Objective: To describe early complications and management of the small for gestational age (SGA) neonate.

Methods: This systematic evidence review is based on Pubmed search, Cochrane library and experts recommendations. Words included in the search mainly were: small for gestational age, intrauterine growth restriction, fetal growth restriction, very low birth weight infants, neonatal management, neonatal outcome, neonatal morbidity, neonatal mortality

Results: Neonatal mortality relative risk among SGA infants is 2-4 times higher than adapted for gestational age (AGA) newborn infants, at any gestational age. SGA infants had an increased risk for perinatal asphyxia, hypothermia and hypoglycaemia during their first days of life. In the SGA preterm population, bronchopulmonary dysplasia, pulmonary hypertension and necrotising enterocolitis are significantly more frequent as compared with AGA population. Periventricular leukomalacia is not significantly different between SGA and AGA infants whereas intraventricular hemorrhage and retinopathy risks are discussed. Adaptive problems require paediatric contact before birth. Early management of the small for gestational age includes intervention to prevent hypothermia, the use of pressure controlled ventilator if needed, and close blood glucose monitoring.

Conclusions: SGA infants had excess neonatal mortality and morbidity in comparison with adapted ones for gestational age (AGA) infants, especially for preterm infants.