Small for Gestational Age. Causes and Consequences

Small for Gestational Age. Causes and Consequences

Pediatric and Adolescent Medicine Vol. 13 Series Editors Wieland Kiess Leipzig David Branski Jerusalem

Small for Gestational Age Causes and Consequences Volume Editors Wieland Kiess Leipzig Steven D. Chernausek Oklahoma City, Okla. Anita C.S. Hokken-Koelega Rotterdam 23 figures, 7 in color, and 17 tables, 2009 Basel Freiburg Paris London New York Bangalore Bangkok Shanghai Singapore Tokyo Sydney

Prof. Wieland Kiess, MD Hospital for Children and Adolescents University of Leipzig Leipzig, Germany Prof. Steven D. Chernausek, MD Children s Medical Research Institute (CMRI) Diabetes and Metabolic Research Program Department of Pediatrics University of Oklahoma Health Sciences Center, Oklahoma City, Okla., USA Prof. Anita C.S. Hokken-Koelega, MD, PhD Division of Endocrinology Department of Paediatrics, Sophia Children s Hospital Erasmus University Medical Center, Rotterdam The Netherlands Library of Congress Cataloging-in-Publication Data Small for gestational age : causes and consequences / volume editors, Wieland Kiess, Steven D. Chernausek, Anita C.S. Hokken-Koelega. p. ; cm. -- (Pediatric and adolescent medicine, ISSN 1017-5989 ; v. 13) Includes bibliographical references and index. ISBN 978-3-8055-8657-3 (hard cover : alk. paper) 1. Fetal growth retardation. 2. Birth weight, Low. I. Kiess, W. (Wieland) II. Chernausek, Steven D. III. Hokken-Koelega, Anita C.S. IV. Series. [DNLM: 1. Fetal Growth Retardation--physiopathology. 2. Infant, Small for Gestational Age. 3. Fetal Growth Retardation--etiology. W1 PE163HL v.13 2008 / WS 420 S635 2008] RG629.G76.S63 2009 618.3 2--dc22 2008031195 Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents. Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 2009 by S. Karger AG, P.O. Box, CH 4009 Basel (Switzerland) www.karger.com Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel ISSN 1017 5989 ISBN 978 3 8055 8657 3

Contents VII Preface Kiess, W. (Leipzig); Chernausek, S.D. (Oklahoma City, Okla.); Hokken-Koelega, A.C.S. (Rotterdam) 1 Children Born Small for Gestational Age: Definitions and Etiology Wollmann, H.A. (Tübingen/Tadworth) 11 Diagnosis and Management of in utero Growth Failure Odibo, A.O.; Sadovsky, Y. (St. Louis, Mo.) 26 Fetal Growth Restriction and the Developmental Origins of Adult Disease Hypothesis: Experimental Studies and Biological Consequences Krechowec, S.O.; Thompson, N.M.; Breier, B.H. (Auckland) 44 Molecular Genetic Disorders of Fetal Growth Chernausek, S.D. (Oklahoma City, Okla.) 60 Birth Weight and Later Risk of Type 2 Diabetes Harder, T.; Schellong, K.; Rodekamp, E.; Dudenhausen, J.W.; Plagemann, A. (Berlin) 73 Low Birth Weight and Optimal Fetal Development: A Global Perspective Franko, K.L.; Gluckman, P.D. (Auckland); Law, C.M. (London); Beedle, A.S.; Morton, S.M.B. (Auckland) 86 Insulin-Like Growth Factor/Growth Hormone Axis in Intrauterine Growth and Its Role in Intrauterine Growth Retardation Kiess, W.; Kratzsch, J.; Knüpfer, M.; Robel-Tillig, E.; Pulzer, F.; Pfaeffle, R. (Leipzig) 99 Clinical Management of Small-for-Gestational-Age Babies Knüpfer, M. (Leipzig) 116 Management of Short Stature in Small-for-Gestational-Age Children Dahlgren, J. (Göteborg) 127 Puberty and Adrenarche in Small-for-Gestational-Age Children Hokken-Koelega, A.C.S. (Rotterdam)

134 Neurological and Intellectual Consequences of Being Born Small for Gestational Age Tuvemo, T.; Lundgren, E.M. (Uppsala) 148 Low Birth Weight in Developing Countries Qadir, M.; Bhutta, Z.A. (Karachi) 163 Author Index 164 Subject Index VI Contents

Preface For medical, ethical, socioeconomic and humanitarian reasons, it is mandatory to foster research into causes and consequences of intrauterine growth retardation in the human. While a lot is known about the causes and consequences of being born small for gestational age, even more has yet to be discovered until the ethical, socioeconomic and health challenges and dilemmas of low birth weight have been dealt with. This book aims to address the most urgent questions and most relevant issues in terms of the clinical care of small for gestational age infants. In addition, frontiers of research into the causes and consequences of being born small for gestational age are being discussed. H. Wollmann from the University of Tübingen, Germany, has worked in the area of pediatric endocrinology and neonatology both as a clinician and as a clinician scientist for more than two decades. He sets the stage with his chapter on definitions and the etiology of being born small for gestational age. In their chapter on the diagnosis and management of in utero growth failure, Odibo and co-workers from St. Louis, Mo., USA, delineate the prenatal etiology and manifestations of growth retardation. They point out that therapeutic measures during intrauterine life would be and will be the ultimate prevention and treatment of all disorders leading to small-for-gestational age birth. The origins of adult metabolic disorders are thought to be found in fetal growth restriction. In their chapter, Krechowec and co-workers report on their fascinating studies with regard to the developmental origins of adult diseases after fetal growth restriction. Chernausek from the University of Oklahoma, USA, draws attention to the wealth of knowledge that today abounds in relation to molecular genetic disorders of fetal growth. He is among the most successful researchers in this area of science and an experienced pediatric endocrinologist involved in the care of SGA children. Harder s group from Berlin, Germany, discuss the hypothesis of the developmental/fetal origins of adult disease in a most elegant way. Franke and co-workers from New Zealand draw VII

our attention to the global perspective of low birth weight: it is very clear today that optimal fetal development ensures good postnatal health. In a short chapter, the group from Leipzig, Germany, summarizes our knowledge on the role of the GH/IGF system in respect to fetal growth. Knüpfer, Leipzig, Germany, suggests practical algorhythms for the clinical management of small-for-gestational-age babies from the neonatologist s point of view. Dahlgren, Göteborg, Sweden, writes on the management of short stature in SGA children, while Hokken-Koelega from the Sophia Children s Hospital, Rotterdam, The Netherlands, reports on her very extensive experience in the regulation of puberty and adrenarche in SGA children. Tuvemo and co-workers from Uppsala, Sweden, summarize our knowledge of neurological and intellectual consequences of being born small for gestational age. This aspect has very long range sequelae and is of utmost importance. It is not just growth, metabolic and cardiovascular consequences that make life for SGA children special but also their development that raises concern and needs attention. Finally, Qadir s group from Karachi, Pakistan, give deep insight into the causes and consequences of low birth weight in developing countries. Interventions that affect maternal and child undernutrition and nutrition-related outcomes include promotion of breastfeeding; strategies to promote complementary feeding, with or without provision of food supplements; micronutrient interventions; general supportive strategies to improve family and community nutrition, and reduction of disease burden. The editors wish to thank Dr. Thomas Karger and his devoted staff at S. Karger, Publishers, Basel, Switzerland, for making this volume possible. We all wish to dedicate this book to Steven Karger who sadly was not able to see it in its finished state. We hope that the readers will gain new insights into the causes and consequences of small-for-gestational-age children and draw strength for the care of babies from their new knowledge and insights. Wieland Kiess, Leipzig Steven D. Chernausek, Oklahoma City, Okla. Anita C.S. Hokken-Koelega, Rotterdam VIII Preface