Institut National de la Santé et de la Recherche Médicale CIE 05-Unité d'épidémiologie clinique, 48, Boulevard de Sérurier, Hôpital Robert Debré, F-75019 Paris, France.
J Clin Endocrinol Metab. 2012 Dec;97(12):4407-13. doi: 10.1210/jc.2012-1993. Epub 2012 Sep 18.
Being born small for gestational age (SGA) is regarded as a risk factor for later metabolic complications. The SGA is defined as a birth weight below -2 SD of the distribution for sex and gestational age. However, the definition of SGA does not distinguish between those born after fetal growth restriction and innate SGA (iSGA).
Our objective was to test whether innate SGA infants show any metabolic complications at the age of 2 yr in comparison with infants born appropriate for gestational age (AGA).
Fifty-eight infants with family SGA risk factors (SGA in a previous pregnancy or among parents, maternal height less than -2 sd for adult height in French women, and small fetal size at second-trimester ultrasound examination) were prospectively followed from midgestation to 2 yr of age. Fetal growth velocity was measured from ultrasound measurements. Body composition and hormonal profile were measured at birth and 1 and 2 yr.
Fetal growth velocity was not significantly different between iSGA and AGA (-0.17 ± 0.2 vs. -0.17 ± 0.3 percentiles/d of gestation; P = 0.96). iSGA infants were significantly lighter at birth (-1.7 ± 0.45 vs. 0.46 ± 0.77 SD; P < 0.0001) and at 4 months of age (-0.85 ± 0.88 vs. 0.29 ± 1 SD; P < 0.0001), and they remain so over follow-up (-0.73 ± 1.08 vs. 0.2 ± 1.02 SD; P = 0.0014 at 2 yr). Height z-scores and percent fat time courses followed a similar pattern. No differences in any of the metabolic and hormonal parameters were observed between iSGA and AGA up to 2 yr (insulin at birth, 5.1 ± 6.8 vs. 5.2 ± 4.6 mIU/liter, P = 0.2; at 2 yr, 2 ± 1.6 vs. 2 ± 1.5 mIU/liter, P = 0.66).
Infants born iSGA do not experience severe fetal growth restriction and do not show any evidence of metabolic risk either at birth or in the first 2 yr of life.
出生体重小于胎龄儿（SGA）被认为是日后发生代谢并发症的危险因素。SGA 的定义为出生体重低于同胎龄、性别身长曲线的第 2 个标准差。但是，SGA 的定义并没有区分由于胎儿生长受限而导致的 SGA 与内在 SGA（iSGA）。
我们的目的是检测与适于胎龄儿（AGA）相比，iSGA 婴儿在 2 岁时是否存在任何代谢并发症。
58 名婴儿具有家族性 SGA 危险因素（前一次妊娠或父母中有 SGA、母亲身高低于法国女性的成人身高-2 个标准差，以及中孕期超声检查时胎儿大小较小），从妊娠中期开始前瞻性随访至 2 岁。从超声测量中计算胎儿生长速度。在出生时、1 岁和 2 岁时测量身体成分和激素谱。
iSGA 与 AGA 之间的胎儿生长速度无显著差异（-0.17±0.2%/妊娠天数与-0.17±0.3%/妊娠天数；P=0.96）。iSGA 婴儿在出生时（-1.7±0.45 与 0.46±0.77 标准差；P＜0.0001）和 4 个月时（-0.85±0.88 与 0.29±1 标准差；P＜0.0001）明显更轻，并且在随访期间仍然如此（-0.73±1.08 与 0.2±1.02 标准差；P=0.0014 在 2 岁时）。身高 z 评分和体脂百分比的时间进程遵循相似的模式。在 2 岁时，iSGA 与 AGA 之间在任何代谢和激素参数方面均无差异（出生时胰岛素，5.1±6.8 与 5.2±4.6 mIU/l，P=0.2；2 岁时，2±1.6 与 2±1.5 mIU/l，P=0.66）。
iSGA 出生的婴儿没有经历严重的胎儿生长受限，并且在出生后或 2 岁内没有任何代谢风险的证据。
