The incidence rates of FGR SGA in preterm infants vary according to whether data collection was based on birth weight or gestational age. An estimated 22% of neonatal death are attributed to being born FGR SGA, with the highest number reported in South Asia. Children born FGR SGA have a higher risk of mortality and morbidity during the neonatal period and beyond. In comparison, approximately 11% of infants in rich and developed countries were born FGR SGA. The prevalent rate for FGR SGA is higher in resource-poor countries with the highest-burden in South Asia, where up to 34% of infants were born FGR SGA. The prevalence of FGR SGA varies across different populations. The purpose of this review is to highlight the current trends in the management of children born with FGR SGA. However, newborns with FGR SGA are at increased risk for other complications such as prematurity, neonatal asphyxia, hypothermia, hypoglycemia, hypocalcemia, polycythemia, sepsis, and death. Recent studies have shown that catch-up growth is possible and normal size can be reached at nine months in about 80% of newborns with FGR SGA. The causes of FGR SGA are diverse and range from fetal, maternal, uterine/placental to demographic factors. The prevalence of FGR SGA in high-income countries such as the United States and Australia is approximately 11%, however in low and middle-income countries, an estimated 32.5 million infants were born FGR SGA, and the majority of these infants, an estimated 53% (16.8 million), were born in South Asia. In this article, we focused on infants with SGA secondary to FGR (FGR SGA) Therefore, in making a distinction between SGA and FGR, it is important to use fetal growth curves customized based on constitutional factors to distinguish normal SGA infants from those with FGR. However, SGA cannot be used as a marker for FGR because some infants with FGR will have a birth weight greater than the 10th percentile. Many infants who are SGA have FGR, and many infants with FGR are SGA as well. SGA and fetal growth restriction (FGR) are used interchangeably but are not synonymous. The constitutionally normal infants have normal birth weight less than 10th percentile because of inherent factors such as maternal height, weight, ethnicity, parity, and in these infants, there is no increased risk of perinatal mortality and morbidity. SGA infants are categorized into two major groups: constitutionally normal infants who are SGA and infants who are SGA because of growth restriction with a birth weight lower than expected optimal birth weight. Small for gestational age (SGA) is defined as a birth weight of less than 10th percentile for gestational age.
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