Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2025, Vol. 21 ›› Issue (04): 482 -489. doi: 10.3877/cma.j.issn.1673-5250.2025.04.015

Review

Research progress on perinatal period and prognosis of small for gestational age infants

Mingyu Li1, Yanghuan Deng1, Xiangyi Zheng1, Bin Xia2,3,()   

  1. 1Department of Neonatology, Meishan Maternity and Child Health Hospital, Meishan 620010, Sichuan Province, China
    2Department of Neonatology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    3Department of Neonatology, WCSUH-Tianfu·Sichuan Provincial Children′s Hospital, Meishan 620010, Sichuan Province, China
  • Received:2025-06-05 Revised:2025-07-09 Published:2025-08-01
  • Corresponding author: Bin Xia
  • Supported by:
    National Natural Science Foundation of China(81370738)

At present, the literature reports on the incidence of small for gestational age (SGA) infants in the world are not uniform, ranging from 6.61% to 12.28%. Compared with appropriate for gestational age (AGA) infants, SGA infants have higher mortality, and higher perinatal complications and long-term complications. Early identification of SGA infants related risk factors and complications, and timely intervention are the key to improve their long-term prognosis. The author intends to review the latest research progress in three aspects about epidemiological research status of SGA infants, high risk factors and prevention of SGA infants, perinatal complications and prognosis of SGA infants, and intervention measures for SGA infants after birth and related measures to improve prognosis, in order to provide reference for further clinical research on the diagnosis and treatment of SGA infants.

[1]
Hokken-Koelega ACS, van der Steen M, Boguszewski MCS, et al. International consensus guideline on small for gestational age: etiology and management from infancy to early adulthood[J]. Endocr Rev, 2023, 44(3): 539-565. DOI:10.1210/endrev/bnad002.
[2]
王庆红,杨于嘉,魏克伦,等. 我国小于胎龄儿现状分析[J]. 中国实用儿科杂志2009, 24(3): 177-180.
[3]
Lee AC, Katz J, Blencowe H, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010[J]. Lancet Glob Health, 2013, 1(1): e26-e36.
[4]
Ota E, Ganchimeg T, Morisaki N, et al. Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO multi-country survey on maternal and newborn health[J]. PLoS One, 2014, 9(8): e105155. DOI: 10.1371/journal.pone.0105155.
[5]
Cho WK, Jung IA, Suh BK. Current growth status and metabolic parameters of Korean adolescents born small for gestational age: results from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2010-2011[J]. Pediatr Int, 2014, 56(3): 344-348. DOI: 10.1111/ped.12278.
[6]
Kozuki N, Katz J, Christian P, et al. Comparison of US birth weight references and the International Fetal and Newborn Growth Consortium for the 21st century standard[J]. JAMA Pediatr, 2015, 169(7): e151438. DOI: 10.1001/jamapediatrics.2015.1438.
[7]
He H, Miao H, Liang Z, et al. Prevalence of small for gestational age infants in 21 cities in China, 2014-2019[J]. Sci Rep, 2021, 11(1): 7500. DOI: 10.1038/s41598-021-87127-9.
[8]
Zhou R, Yu H, Qian N, et al. Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis[J]. BMC Pregnancy Childbirth, 2023, 23(1): 540. DOI: 10.1186/s12884-023-05799-9.
[9]
Lawn JE, Ohuma EO, Bradley E, et al. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting[J]. Lancet, 2023, 401(10389): 1707-1719. DOI: 10.1016/S0140-6736(23)00522-6.
[10]
王启闯,史俊君,杨斯岚,等. 小于胎龄儿的临床特征及早产小于胎龄儿高危因素分析[J]. 汕头大学医学院学报2022, 35(3): 136-140. DOI: 10.13401/j.cnki.jsumc.2022.03.002.
[11]
Silver RM. Examining the link between placental pathology, growth restriction, and stillbirth[J]. Best Pract Res Clin Obstet Gynaecol, 2018, 49: 89-102. DOI: 10.1016/j.bpobgyn.2018.03.004.
[12]
祝捷,马军. 小于胎龄儿的研究现况[J]. 中国新生儿科杂志2012, 27(1): 68-70. DOI: 10.3969/j.issn.1673-6710.2012.01.027.
[13]
Miremberg H, Grinstein E, Herman HG, et al. The association between isolated oligohydramnios at term and placental pathology in correlation with pregnancy outcomes[J]. Placenta, 2020, 90: 37-41. DOI:10.1016/j.placenta.2019.12.004.
[14]
Chiavaroli V, Castorani V, Guidone P, et al. Incidence of infants born small- and large-for-gestational-age in an Italian cohort over a 20-year period and associated risk factors[J]. Ital J Pediatr, 2016, 42(1): 42. DOI: 10.1186/s13052-016-0254-7.
[15]
Finken MJJ, van der Steen M, Smeets CCJ, et al. Children born small for gestational age: differential diagnosis, molecular genetic evaluation, and implications[J]. Endocr Rev, 2018, 39(6): 851-894. DOI: 10.1210/er.2018-00083.
[16]
Melamed N, Baschat A, Yinon Y, et al. FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction[J]. Int J Gynecol Obstet, 2021, 152(S1): 3-57. DOI: 10.1002/ijgo.13522.
[17]
黄林环,王子莲. 多胎妊娠的孕期监护[J]. 实用妇产科杂志2019, 35(9): 647-650.
[18]
Cao C, Cai W, Niu X, et al. Prehypertension during pregnancy and risk of small for gestational age: a systematic review and Meta-analysis[J]. J Matern Fetal Neonatal Med, 2018: 1-8. DOI: 10.1080/14767058.2018.1519015.
[19]
Yi SW, Han YJ, Ohrr H. Anemia before pregnancy and risk of preterm birth, low birth weight and small-for-gestational-age birth in Korean women[J]. Eur J Clin Nutr, 2013, 67(4): 337-342. DOI: 10.1038/ejcn.2013.12.
[20]
McGrath RT, Fulcher GR, Glastras SJ. Comment on Ooi and Wong. Twin pregnancy with gestational diabetes mellitus: a double whammy? Diabetes Care 2018;41: E15-E16[J]. Diabetes Care, 2018, 41(4): e67. DOI: 10.2337/dc17-2594.
[21]
Gutaj P, Wender-Ozegowska E. Diagnosis and management of IUGR in pregnancy complicated by type 1 diabetes mellitus[J]. Curr Diabetes Rep, 2016, 16(5): 39. DOI: 10.1007/s11892-016-0732-8.
[22]
林晓洁,王芳会,刘俐. 140例小于胎龄儿高危因素及并发症分析[J]. 中国妇幼健康研究2013, 24(1):49-52. DOI: 10.3969/j.issn.1673-5293.2013.01.018.
[23]
Osamor PE, Grady C. Women′s autonomy in health care decision-making in developing countries: a synthesis of the literature[J]. Int J Womens Health, 2016, 8: 191-202. DOI: 10.2147/ijwh.s105483.
[24]
Louw KA. Substance use in pregnancy: the medical challenge[J]. Obstet Med, 2018, 11(2): 54-66. DOI: 10.1177/1753495x17750299.
[25]
Poeran J, Maas AFG, Birnie E, et al. Social deprivation and adverse perinatal outcomes among Western and non-Western pregnant women in a Dutch urban population[J]. Soc Sci Med, 2013, 83: 42-49. DOI: 10.1016/j.socscimed.2013.02.008.
[26]
牛利美,李书书,韩树萍,等. 极早产儿中小于胎龄儿的影响因素与临床特征分析:多中心队列研究[J]. 中华围产医学杂志2024, 27(10): 793-801. DOI: 10.3760/cma.j.cn113903-20240510-00340.
[27]
张璐,杨惠娟,刘凯波. 2015—2021年北京市辅助生殖技术助孕活产及高龄孕母占比与不良妊娠结局变化趋势[J/OL]. 中华妇幼临床医学杂志(电子版), 2023, 19(1): 46-53. DOI: 10.3877/cma.j.issn.1673-5250.2023.01.007.
[28]
蒋晓东,包蕾. 小于胎龄儿发生新生儿呼吸窘迫综合征的危险因素分析[D]. 重庆:重庆医科大学,2021.
[29]
杨华,悦光,巨容. 小于胎龄的极低出生体重儿肠道血流特点及其对消化道并发症的影响[J]. 中国妇幼健康研究2022, 33(3): 41-46. DOI: 10.3969/j.issn.1673-5293.2022.03.007.
[30]
何洋,蔡丽梅,唐军,等. 晚期早产儿中小于胎龄儿和适于胎龄儿的临床特点分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2017, 13(4): 461-465. DOI: 10.3877/cma.j.issn.1673-5250.2017.04.016.
[31]
Lee SM, Namgung R, Park MS, et al. Parenteral nutrition associated cholestasis is earlier, more prolonged and severe in small for gestational age compared with appropriate for gestational age very low birth weight infants[J]. Yonsei Med J, 2013, 54(4): 839-844. DOI: 10.3349/ymj.2013.54.4.839.
[32]
陈瑜,朱雪萍. 小于胎龄早产儿胆汁淤积症的临床特征及危险因素[J]. 中国当代儿科杂志2024, 26(10): 1027-1033. DOI: 10.7499/j.issn.1008-8830.2404095.
[33]
Kobayashi S, Sata F, Hanaoka T, et al. Association between maternal passive smoking and increased risk of delivering small-for-gestational-age infants at full-term using plasma cotinine levels from The Hokkaido Study: a prospective birth cohort[J]. BMJ Open, 2019, 9(2): e023200. DOI: 10.1136/bmjopen-2018-023200.
[34]
Tamai K, Yorifuji T, Takeuchi A, et al. Associations of birth weight for gestational age with child health and neurodevelopment among term infants: a nationwide Japanese population-based study[J]. J Pediatr, 2020, 226: 135-141.e4. DOI: 10.1016/j.jpeds.2020.06.075.
[35]
de Jong M, Cranendonk A, van Weissenbruch MM. Components of the metabolic syndrome in early childhood in very-low-birth-weight infants and term small and appropriate for gestational age infants[J]. Pediatr Res, 2015, 78(4): 457-461. DOI: 10.1038/pr.2015.118.
[36]
Sebastiani G, Díaz M, Bassols J, et al. The sequence of prenatal growth restraint and post-natal catch-up growth leads to a thicker intima-media and more pre-peritoneal and hepatic fat by age 3-6 years[J]. Pediatr Obes, 2016, 11(4): 251-257. DOI: 10.1111/ijpo.12053.
[37]
李力,邹仙,马娟,等. 昆士兰临床指南:小于胎龄新生儿指南解读[J]. 西部医学2022, 34(9): 1255-1259. DOI: 10.3969/j.issn.1672-3511.2022.09.002.
[38]
中国妇幼保健协会新生儿保健专业委员会,中国医师协会新生儿科医师分会. 产科母婴同室新生儿管理建议[J]. 中华新生儿科杂志(中英文), 2017, 32(2): 81-85. DOI:10.3760/cma.j.issn.2096-2932.2017.02.001.
[39]
郭立珍,范天群,张欣凯,等. 早产小于胎龄儿发生支气管肺发育不良的危险因素及预后分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(2): 209-215. DOI: 10.3877/cma.j.issn.1673-5250.2024.02.012.
[40]
张丽娇,李科兴,宋霞. 早产儿暂时性低甲状腺素血症影响因素分析[J]. 吉林医学2016, 37(4): 819-821. DOI: 10.3969/j.issn.1004-0412.2016.04.018.
[41]
张珈宁,侯新琳. 先天性甲状腺功能减退症:2020—2021年欧洲儿科内分泌学学会和欧洲内分泌学学会共识指南更新[J]. 中华新生儿科杂志2022, 37(3): 286-288. DOI: 10.3760/cma.j.issn.2096-2932.2022.03.026.
[42]
中国医师协会儿科医师分会儿童保健学组. NICU出院高危儿0~3岁生长发育随访管理技术的专家共识[J]. 中国儿童保健杂志2021, 29(8): 809-814. DOI: 10.11852/zgetbjzz2020-2035.
[43]
《中华儿科杂志》编辑委员会,中华医学会儿科学分会儿童保健学组,中华医学会儿科学分会新生儿学组. 早产、低出生体重儿出院后喂养建议[J]. 中华儿科杂志2016, 54(1): 6-12. DOI: 10.3760/cma.j.issn.0578-1310.2016.01.003.
[44]
中国优生优育协会婴幼儿发育专业委员会. 高危新生儿行为神经发育早期干预专家共识[J]. 中国儿童保健杂志2022, 30(3): 233-236. DOI: 10.11852/zgetbjzz2021-0625.
[45]
何梅,张鸿,鲜蓉华,等. 439例早产儿及足月小于胎龄儿眼底筛查结果及眼底疾病危险因素分析[J]. 中国中医眼科杂志2023, 33(2): 127-131. DOI: 10.13444/j.cnki.zgzyykzz.2023.02.006.
[46]
中华预防医学会儿童保健分会,中国疾病预防控制中心妇幼保健中心,中国妇幼保健协会高危儿童健康管理专委会. 高危儿规范化健康管理专家共识[J]. 中国儿童保健杂志2023, 31(6): 581-585, 622. DOI: 10.11852/zgetbjzz2023-0347.
[47]
张悦. 我国儿童保健工作中高危儿管理内涵和外延的探析[J]. 中国儿童保健杂志2019, 27(2): 123-125. DOI: 10.11852/zgetbjzz2018-1853.
[1] Bing Luo, Fengqun Dong, Yizhen Niu, Kun Wang, Zhihua Cheng, Hongqiang Liu. Value of fetal echocardiography in severity and prognosis assessment of isolated pulmonary valve stenosis[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(08): 740-747.
[2] Long Qian, Daming Cai, Xingzhou Wang, Shichao Ai, Qiongyuan Hu, Feng Sun, Peng Song, Feng Wang, Meng Wang, Xiaofeng Lu, Huanhuan Zhu, Xiaofei Shen, Wenxian Guan. Analysis of risk factors associated with lymph node metastasis after conversion therapy (combined with immunotherapy) for locally unresectable gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 624-627.
[3] Yuefang Xu, Linsen Yang, Chuntong Li. Analysis of high-risk factors for linezolid-Induced thrombocytopenia in postoperative surgical infections[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 682-684.
[4] Xidong Chen, Shaochuang Wang, Hewei Zhao, Shuo Wang, Weidong Yuan. Study on risk factors for acute hepatic function deterioration after conventional TACE in elderly patients with BCLC stage B hepatocellular carcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 689-692.
[5] Yali He, Li Huang, Peijuan Yang. Research progress of function-preserving surgery in the treatment of low rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 701-704.
[6] Ning Chen, Xin Zhao, Yuan Zhou, Bing Liu, Jin Dou, Jian Wang, Xiaoyu Zhang, Haijian Zhao. Predicting strangulated versus non-strangulated incarcerated inguinal hernias: a study based on a multivariable logistic regression model[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(05): 539-543.
[7] Yan Zhang, Dingwei Xu, Manqin Hu, Haoyang Huang, Guangna Song, Jie Huang. Predictive value of preoperative inflammatory immune indexes for survival and prognosis of patients with hepatocellular carcinoma after hepatectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(05): 707-715.
[8] Xingbao Fang, Guolian Pang, Yuehong Li, Yan Cai. Multiomics-based analysis of expression of MCAM in hepatocellular carcinoma and its relationship with survival prognosis and immune cell infiltration[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(05): 716-724.
[9] Jiale Chen, Anhai Yu, Wenkang Yuan, Chao Zhang, Chong Zhang. Perioperative monitoring and management of liver resection[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(05): 785-788.
[10] Nan Zhao, Mingkai Zhang, Bhargava Divija, Shiguang Zhao, Daming Zhang. Clinical features and strategic advances in the treatment of brain metastases from colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(05): 427-435.
[11] Bo Han, Hongshuai Cui, Qian Ju, Lin Zhang. Application effects and prognosis analysis of different anastomosis methods in laparoscopic right hemicolectomy for colon cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(05): 431-435.
[12] Houning Zhou, Qiaoling Cui, Ruibiao Fu. Evaluation of nutrition risk index, nutritional control status score and urea-creatinine ratio on nutrition and prognosis of patients with gastric cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(05): 444-448.
[13] Yonghui Zhu, Di Sang, Jia Song. Construction and clinical validation of a nomogram prediction model for postoperative skeletal muscle reduction in patients undergoing extensive hepatectomy for liver cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(05): 467-473.
[14] Zhen Li, Rui Wang. Establishment and validation of a risk prediction model for delayed recovery from general anesthesia in elderly patients with colorectal cancer after laparoscopic radical surgery[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(05): 517-523.
[15] Li Zang, Li Chen, Juan Yu. Relationship between self-efficacy, sleep quality and mental state in patients with inflammatory bowel disease[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(05): 546-551.
Viewed
Full text


Abstract