Symptoms for Small for Gestational Age

Despite their size, small for gestational age newborns usually look and act similar to normal-sized newborns of similar gestational age. Some small for gestational age newborns appear thin and have less muscle mass and fat, and some have sunken facial features (called wizened facies). The umbilical cord can appear thin and small.

Immediate complications

During pregnancy, growth-restricted fetuses are at increased risk of miscarriage or stillbirth. At birth, small for gestational age newborns who are born full-term do not have the complications related to organ system immaturity that premature newborns of similar size have. They are, however, at increased risk of the following problems:

• Perinatal asphyxia: This complication is a decrease in blood flow to the baby's tissues or a decrease in oxygen in the baby's blood before, during, or just during delivery. It may result from a problem with the placenta before or during delivery.
• Meconium aspiration: Growth-restricted fetuses may pass meconium (dark green fecal material that is produced in the fetus's intestine before birth) in the amniotic fluid and take forceful; gasps and breath (aspirate) the meconium-containing amniotic fluids into their lungs
• Low blood sugar (glucose) levels (hypoglycemia): This complication often occurs in the early hours and days of life because the small newborn does not have enough stored carbohydrates to use for energy and cannot adequately process the carbohydrates it does have.
• Excess red blood cells (polycythemia): Small for gestational age babies may have a higher blood count than usual, and too many red blood cells cause the blood to become too thick, which may slow blood flow. Newborns with polycythemia have a reddish complexion and are sluggish. Polycythemia also can contribute to hypoglycemia, respiratory distress, and hyperbilirubinemia.
• Difficulty regulating body temperature: This complication occurs because small for gestational age newborns have less fat and body weight to keep them warm and they do not have enough carbohydrates to use for energy.
• Increased risk of infection: Small for gestational age newborns may have an impaired immune system, which increases their risk of developing infections in the hospital.

Long- term complications

Recent studies suggest that intrauterine growth restriction increases the likelihood of problems during adulthood, increasing heart disease, high blood pressure, and stroke.