By Dr. Disu Consultant Paediatrician LASUTH BIRTH WEIGHT CLASSIFICATION
• Normal birth weight (NBW) 2,500 – 3,999g
• Low birth weight (LBW) 2,500g • Very low birth weight less than (VLBW) 1500g • Extreme low birth weight less than(ELBW) 1000g Small For Gestation Age • SGA describes a baby whose birth weight is below the 10th percentile for age and sex. • It may also be defined as birth weight more than two standard deviations below the mean for age and sexWeight below 10th centile for gestation • Roberton(1999) states that 50% of babies that are SGA there is no known cause. These babies are proportionally small in all the parameters. Babies are well & healthy. Regulators of fetal growth Normal fetal growth is dependent on the -mother, -placenta and -fetus Regulators of fetal growth • Genetics • Environmental factors • Placental function • Growth factors , hormones etc Intrauterine Growth Restriction • Head appears large in relation to body • Skin dry, thin layer of subcutaneous fat • Baby looks anxious • Neurological assessment usually corresponds to gestation • Increased morbidity and mortality when compared to AGA neonates of same GA. Asymmetrical Growth Restriction • Normally in the third trimester • Associated with insult such as pregnancy induced hypertension • Head circumference & length normal but weight is low in proportion to those parameters • Growth restriction as a result of malnutrition Symmetrical Growth Restriction • Earlier in pregnancy: • Intrauterine infections • Substance abuse • Head circumference is in proportion to weight & length Problems of the low birth weight baby (SGA) – Hypothermia as a result of low subcutaneous fat – Increased susceptibility to infection – Polycythaemia resulting from excessive stimulation of bone marrow by intrauterine hypoxia – HIE – Congenital anomalies Dysmorphology – Pulmonary haemorrhage – Persistent pulmonary hypertension – Meconium aspiration – Hypoglycaemia/ tissue glycogen – Polycythemia –due to fetal hypoxia – Acute tubular necrosis / renal insufficiency Causes of Large for Gestational Age • Constitutionally large infants (large parents) • Infants of diabetic mothers • Some post-term infants • Beckwith-Wiedemann and other syndromes Problems of LGAs • Birth injuries • Perinatal asphyxia • Hypoglycaemia • Hyperbilirunaemia