Adult height distribution in subjects born small for gestational age

The aim of the study was to investigate the post-natal growth of subjects born small for gestational age (SGA) by describing adult height distribution and by testing the effects of parental, neonatal and pregnancy-related parameters on the risk for adult short stature. The study population was made of adults selected on birth data from a maternity registry and born either small (SGA, n = 734, birth weight < 10th percentile) or appropriate for gestational age (AGA, n = 886, 25th < birth weight < 75th percentile) in whom anthropometric parameters were measured at 22 years of age. The SGA group demonstrated significantly reduced body size in comparison to the AGA group with a mean loss of 0.7 standard deviation (SD) in adult height. The frequency of adult short stature (< -2 SD) was 10.3% in the SGA group vs. 2.4% in the AGA group (p = 0.0001), adult height < -2.5 SD was observed in only 3.7% of the SGA group. Maternal (OR = 0.31 (0.16-0.62), p = 0.0001) and paternal (OR = 0.45 (0.31-0.67), p = 0.0001) heights and subjects birth length (OR = 0.78 (0.62-0.99), p = 0.04) significantly influenced the risk of adult short stature. In summary, post-natal growth defect remains moderate in the majority of subjects born SGA and < 4% only will end up with severe short stature requiring GH therapy according to most current recommendations. The role of parental height and birth length suggests that adult short stature in SGA subjects results at least in some cases from a familial and likely genetic growth disorder with antenatal onset.     

Selenium status, birth weight,

Selenium (Se) is an essential nutritional element for humans. A low Se status has been documented in formula-fed small-for-gestational age (SGA) newborns in the first month of life. The aim of the study was to compare the nutritional selenium status in adequate-for-gestational age (AGA) and in SGA newborns in the first month of life in relation to feeding type. Se status was assessed by plasma and erythrocyte concentrations, determined by pulsed Zeeman effect-atomic absorption spectrophotometry. We studied 210 newborns divided in groups according to birth weight (129 AGA, 81 SGA ) and feeding type (breast milk, formula, mixed) in wk 1-4 of postnatal life. Erythrocyte Se levels are affected neither by feeding type nor by birth weight. Se plasmatic concentrations were lower in SGA than in AGA newborns. Significant differences in mean plasma concentrations were found between formula-fed and breast-fed (p=0.013) and between formula-fed and mixed-fed (p=0.006) SGA newborns. The difference was not significant in AGA neonates. Breast-fed SGA newborns consistently showed higher plasma Se concentrations than formula-fed newborns. Unless supplemented from birth, Se intake will be inadequate in bottle-fed SGA infants.     

Growth hormone treatment in short Japanese children born small for gestational age

Recent reports have shown that high-dose growth hormone (GH) treatment in short children born with small for gestational age (SGA) resulted in a pronounced acceleration of linear growth. We describe the results of multicenter trials of recombinant human GH (rhGH) treatment in short SGA children in Japan. Two clinical studies were performed and the results were combined. Study 1 comprised 104 SGA children and study 2 comprised 61 SGA children. The patients were divided into three groups: group 1 consisted of 20 patients (13 boys and 7 girls) who received rhGH 25 microg/kg per day six or seven times per week in the first year and 50 microg/kg per day in the second year and thereafter; group 2 consisted of 48 patients (28 boys, 20 girls) who received rhGH 45/50 microg/kg per day; group 3 consisted of 44 patients (28 boys, 16 girls) who received 90/100 microg/kg per day. The mean increments in height SDS were 0.46, 0.67 and 0.94 SD in boys and 0.49, 0.79 and 0.93 SD in girls in groups 1, 2 and 3, respectively. The mean increment in height SDS at 2 years in group 3 was significantly greater than that in group 1, but it was not significantly different from that in group 2 in boys and girls. Our data demonstrated that high-dose GH administration significantly improved height velocity and height SDS in short SGA children. Additional studies are necessary to optimize a long-term GH treatment regimen and combined luteinizing hormone releasing hormone analog treatment for final height. Careful observation is also necessary to assess the metabolic effects of high-dose GH, especially on carbohydrate metabolism.     

Artificial immunization of pigeons against Argas polonicus (Ixodoidea, Argasidae)

Two subcutaneous injections of salivary gland antigen (SGA) or larval homogenate (LH) at 2-week intervals induced a resistance in pigeons to Argas (Argas) polonicus Siuda, Hoogstraal, Clifford and Wassef larvae and induced anti-tick antibodies. The number of larvae rejected after LH immunization was significantly higher compared to SGA immunization but lower than the number of larvae rejected after two natural infestations at 2-week intervals. The antibody titre reached a peak on day 6 following the first inoculation of LH, and 11-13 days after SGA inoculation. The maximum antibody titre was recorded 6 days after a second challenge for both antigens. The highest antibody titre was reached after the first inoculation with LH but only after the second inoculation with SGA. The sera of pigeons immunized either with SGA or LH cross-reacted with the other antigen as demonstrated by ELISA. SDS-PAGE and immunoblot studies demonstrated several differences in the protein profiles of these antigens, the presence of 34 and 35 kdal proteins in SGA and their absence in LH.     

Association of genetic variants of ghrelin, leptin and UCP2 with malnutrition inflammation syndrome and survival in end-stage renal disease patients

Malnutrition inflammation syndrome (MIS) is common among ESRD patients. In the present study, we have investigated the association of genetic markers associated with appetite and energy regulation with malnutrition inflammation syndrome among end-stage renal disease (ESRD) patients. Two hundred and fifty-seven patients on maintenance hemodialysis and 200 normal healthy controls were included in the study. Nutritional assessment was done by subjective global assessment scores (SGA). Genotyping of leptin-2548 G/A (rs7799039), ghrelin Leu72Met (rs696217-408 C/A), Arg51Gln (rs34911341-346 G/A) and uncoupling protein 2 (UCP2) 45 bp insertion deletion was done using PCR–RFLP. Levels of leptin and acyl ghrelin were assessed using ELISA. Leptin-2548 AA genotype was associated with twofold higher risk of disease susceptibility while UCP2 insertion–deletion heterozygotes showed protective effect. Ghrelin Gln51Gln and Met72Met genotype were associated with 3.4- and 2.5-fold higher disease susceptibility. The Met72 and Gln51 allele showed 3.3- and 2.1-fold higher susceptibility to malnutrition in severe SGA group. Further, the levels of acyl ghrelin were significantly less in severe category of malnutrition and in poor appetite group. On combined analysis, the group 2 (presence of 3–4 risk alleles) showed 1.5- and twofold higher susceptibility to disease and malnutrition, respectively. On docking analysis, it was observed that higher receptor binding energy was associated with the mutant form of ghrelin (Gln51). Moderate and severe SGA were associated with 2.2- and 4.1-fold higher death hazard. Our study suggests that ghrelin may be major marker contributing to susceptibility to MIS among ESRD patients.     

Satoyama–satoumi sub-global assessment in Japan and involvement of the Hokkaido Cluster

A sub-global assessment (SGA) began in Japan in November 2006, and is projected to end in May 2010, when the Tenth Conference of the Parties to the Convention on Biological Diversity (COP10) will be held in Nagoya City. Since May 2008, we have been involved in the evaluation of the Hokkaido Cluster, one of four clusters assessed. This report provides a brief background of the relationships between the Millennium Ecosystem Assessment (MA) and the SGA, and the governance structure of the SGA in Japan. It also describes our efforts in assessing the Hokkaido Cluster and discusses the challenges of SGA at the cluster and national levels. The MA was a 4-year international appraisal of scientific knowledge on world ecosystems and included global and sub-global assessment. After the MA, Japan began a satoyama–satoumi SGA in 2006. This is composed of six teams: the board, a science assessment panel, author groups, local advisory bodies, the board of review editors, and secretariat. Author groups include a national group and groups for four local clusters: Hokkaido, Tohoku, Hoku-shin-etsu, and Western Japan. Work in the Hokkaido Cluster began with a small group in 2008. Authors for the cluster report were selected from among experts on important events regarding satoyama and satoumi in Hokkaido. Generally, Hokkaido has no traditional satoyama–satoumi landscapes created by long-term interactions with the local people. We are now seeking the style of sustainable nature use that is best suited to Hokkaido. The SGA in Japan now faces the challenge of integrating the four cluster assessments according to common indicators.     

Composition and properties of a group A streptococcal teichoic acid

Teichoic acid-like material extracted by cold trichloroacetic acid from lyophilized whole cells of streptococci from groups A,D,E,O, and T was shown to give a positive precipitin reaction with group antisera. Similar material from cells of groups B,C,F,G,H,K,L,M,N,P,Q,R, and S did not give a positive reaction with group antisera. The group A material also reacted with anti-E serum; however, the opposite did not occur. A similar result was also obtained on the group T material and anti-O serum. The group A teichoic acid was purified by Sephadex column chromatography, and was shown to be free of cell wall peptidoglycan and polysaccharide, and ribitol teichoic acid. It was composed of glycerol, phosphate, alanine, and glucosamine. Alkaline hydrolysis showed the presence of ester-linked alanine and glucosaminylglycerol. Phosphorus was released from ester linkage by alkaline phosphatase. N-acetylglucosamine produced a 72% inhibition of the precipitin test at a level of 10 mumoles, and d-alanine methyl ester was significantly stronger than the l-alanine ester. A single precipitin band was seen with group A serum. The data indicate that teichoic acid of group A streptococci is a polymer composed of glycerol phosphate and containing N-acetylglucosamine and alanine. Antisera to these streptococci contain antibodies specific for the alanine and the glucosamine linkages. The use of serum containing antibodies to alanine-polyglycerophosphate shows that the occurrence of this type of teichoic acid is widespread among the streptococci.     

US experience in evaluation and diagnosis of GH therapy of intrauterine growth retardation/small-for-gestational-age children

The potential role of exogenous GH in treating short children born small for gestational age (SGA) has been discussed since the early 1960s. Pivotal studies in Europe during the last 10 years have shown that GH treatment of short children born SGA during childhood and early puberty (1) normalizes stature, (2) increases final height above predicted height and (3) allows children to reach their target height. A study now under way in the USA will provide additional much needed data about efficacy and safety of GH treatment in intrauterine growth retardation/SGA.     

Rapid recovery of fat mass in small for gestational age preterm infants after term

Background

Preterm small for gestational age (SGA) infants may be at risk for increased adiposity, especially when experiencing rapid postnatal weight gain. Data on the dynamic features of body weight and fat mass (FM) gain that occurs early in life is scarce. We investigated the postnatal weight and FM gain during the first five months after term in a cohort of preterm infants.

Methodology/Principal Findings

Changes in growth parameters and FM were prospectively monitored in 195 infants with birth weight ≤1500 g. The infants were categorized as born adequate for gestational age (AGA) without growth retardation at term (GR−), born AGA with growth retardation at term (GR+), born SGA. Weight and FM were assessed by an air displacement plethysmography system. At five months, weight z-score was comparable between the AGA (GR+) and the AGA (GR−), whereas the SGA showed a significantly lower weight.The mean weight (g) differences (95% CI) between SGA and AGA (GR−) and between SGA and AGA (GR+) infants at 5 months were −613 (−1215; −12) and −573 (−1227; −79), respectively. At term, the AGA (GR+) and the SGA groups showed a significantly lower FM than the AGA (GR−) group. In the first three months, change in FM was comparable between the AGA (GR+) and the SGA groups and significantly higher than that of the AGA (GR−) group.The mean difference (95% CI) in FM change between SGA and AGA (GR−) and between AGA (GR+) and AGA (GR−) from term to 3 months were 38.6 (12; 65); and 37.7 (10; 65). At three months, the FM was similar in all groups.

Conclusions

Our data suggests that fetal growth pattern influences the potential to rapidly correct anthropometry whereas the restoration of fat stores takes place irrespective of birth weight. The metabolic consequences of these findings need to be elucidated.     

Peak systolic velocity Doppler of middle cerebral artery in small for gestational age (SGA) fetus

Background

Small for gestational age (SGA) has high frequency which increases the risk of long-term adverse outcomes. Thus the aim of this study was to evaluate peak systolic velocity Doppler of middle cerebral artery (MCA) in SGA fetus in order to find appropriate method to diagnosis SGA sooner.

Materials and Methods

This prospective longitudinal study was conducted on 90 pregnant women with a diagnosis of SGA fetus and 90 pregnant women with normal fetus. Then MCA and umbilical artery assessment were performed for all subjects and compared between two groups.

Results

Doppler assessment showed that umbilical artery PI was significantly higher in SGA group as compared to normal group (1.11±0.37 vs 0.98±0.18, P = 0.003), while MCA PI was significantly lower in SGA group (1.77±0.44 vs 1.92±0.47, P = 0.028). On the other hand, PSV did not differ between the groups (P = 0.592). Moreover, we found that PSV was more in SGA group by grouping maternal age (<27 years) (P = 0.006), and gestational age (>34 weeks) (P<0.001).

Conclusion

The results of this study suggest that MCA PI decreased significantly in SGA fetuses, while UA PI increased in this group. Moreover, PSV increased in this group when evaluated in different subgroups (based on maternal age and gestational age).

     

Quality of life in adolescents born small for gestational age: does growth hormone make a difference?

BACKGROUND/AIMS: To evaluate quality of life (QoL) in adolescents born SGA without spontaneous catch-up growth, treated with and without long-term growth hormone (GH) therapy. Additionally, to assess whether GH treatment has a positive effect on QoL, besides improving adult height and height SDS during childhood. METHODS: Two groups of adolescents born SGA without spontaneous catch-up growth participated in the QoL evaluation; a GH-treated group (n = 44, mean GH duration: 8.8 (1.7) years) and an untreated group (n = 28), both mean age 15.8 (2.1) years. QoL was measured by self-reports of the TACQOL-S, a disorder-specific questionnaire, and the CHQ, a generic questionnaire. RESULTS: The GH group scored significantly better health status and health-related QoL on several scales of the TACQOL-S. On all TACQOL-S scales the GH group scored better QoL than the untreated group, with effect sizes of moderate to large, not all differences reaching statistical significance. The generic CHQ did not reveal significant differences in QoL between the GH group and the untreated group. CONCLUSIONS: Firstly, adolescents born SGA, with a GH-induced improved height, had in many aspects a better QoL than untreated adolescents born SGA, according to the disorder-specific questionnaire. Secondly, we advise to use, in addition to a generic questionnaire, a disorder-specific questionnaire for measuring QoL in children treated for short stature, as the generic CHQ did not reveal such differences.     

Characteristics of group A streptococcal bacteriophages

Friend, Patric L. (Northwestern University Medical School, Chicago, Ill.), and Hutton D. Slade. Characteristics of group A streptococcal bacteriophages. J. Bacteriol. 92:148-154. 1966.-A medium for the growth of group A streptococcal phages is described, consisting of Brain Heart Infusion broth supplemented with 0.2% yeast extract, 10(-4)m CaCl(2), and 10 mug/ml of dl-tryptophan. Cell and phage growth in this medium was excellent, and did not require the addition of serum or other proteins as indicated by other workers. Growth of one phage has also been achieved in a completely synthetic medium. The adsorption characteristics of two group A phages in protein broth and synthetic broth were studied, and the initial adsorption of phage was found to be more extensive in synthetic broth. However, the final amounts of adsorption in both were similar. The addition of purified group A carbohydrate antigen to the adsorption mixture in synthetic broth had no effect on the adsorption, and cells containing type-specific M protein adsorbed phage at the same rate as those lacking M protein. It was concluded that neither the group antigen nor the type antigen was the primary site of phage adsorption. One-step growth curves of the two phages showed a second step or burst occurring. Sonic oscillation of the bacterial cultures, which broke up the chains to single cells, abolished the second step of the growth curve. It appears that the second step is a function of the chain formation of streptococcal cells.     

Assessment of nutritional status of gastroenterology patients in Croatia

Malnutrition is a common feature of gastroenterological diseases. In this study, nutritional status of the patients admitted to Department of Gastroenterology at University Hospital Center Zagreb was assessed. Anthropometric, dietetic, biochemical methods and method of Subjective Global Assessment (SGA) was used. The study group included 284 patients admitted to the Hospital. Malnutrition, as defined by SGA, was found in 61.1% of the patients, of whom 75% were moderately and 25% severely malnourished. Those patients classified as moderately and extremely malnourished by SGA were found to have statistically lower values of BMI, albumin, total proteins, calcium, iron, triglycerides, cholesterol, vitamin A and lymphocytes as compared to those who were adequately nourished. The prevalence of malnutrition in hospitalized patients treated at the Department of Gastroenterology is high. The use of nutritional screening with multiple measures would be important in the early identification and treatment of these patients and would help decrease this high prevalence.     

Inhibition of saliva-induced oral streptococcal aggregation by blood group glycoproteins

Abstract The inhibition of saliva-induced oral streptococcal aggregation with anti-sera (anti-A, anti-B, anti-AB and anti-B treated with galactose), normal human serum (NHS), blood group-specific lectins (UEA-I, HBA, GPA, BSI-B₄, GS-I), non-specific blood group lectins (MPA, SBA) and carbohydrates (galactose, N -acetylgalactosamine, l -fucose) was studied. Streptococcal species and strains included S. mutans 318, S. mutans 10449, S. mutans NG-8, S. salivarius and S. cricetus HS-6. The saliva was obtained from three subjects with secretor status (2 blood group B persons, 1 blood group A person). The data obtained from experiments performed with S. mutans 10449 and S. mutans NG-8 suggest the involvement of the H-antigenic determinant in the aggregation mechanism of the first strain and of the group B determinant for the second strain. The aggregation of S. salivarius only by B saliva might be related to a galactose-specific lectin on this strain and to some properties of its cell surface (hydrophobicity and the fibrillar surface layer). S. cricetus HS-6 aggregation was inhibited in different degrees by all the inhibitors used. The results demonstrate that interactions between oral streptococci and salivary components depend on the strain and species and on the individual saliva samples.     

Comparative studies on surface hydrophobicity of streptococcal strains of groups A, B, C, D and G

Cell surface hydrophobicity of group A, B, C, D and G streptococcal strains has been studied and compared in a new test based on the fact that the degree of bacterial aggregation in ammonium sulphate depends on amphiphilic surface antigens. M-positive group A strains showing good growth in normal human blood aggregated in the standard salt aggregation test at very low concentrations of ammonium sulphate, while M-negative strains, which were killed in normal human blood, usually aggregated at high salt concentrations. Agents such as 2 M-KSCN, 2 M-guanidine. HC1 or 2 M-urea decreased the aggregation of the M-positive strains in the salt aggregation test while non ionic detergents such as Tween 20 (1%, w/v) and ethylene glycol (2 M) did not affect cell aggregation. Binding of fibrinogen and albumin resulted in a decrease of surface hydrophobicity of the group A M-positive strains. Group B strains possess a hydrophilic surface character and did not aggregate, while group C and G strains behaved in the salt aggregation test like M-negative strains of group A streptococci. Group D strains did not aggregate even at high ammonium salt concentrations. The results are discussed in relation to the influence of lipoteichoic acid and other surface antigens on strains of the various groups, and it is suggested that M protein and possibly also other surface proteins contribute to the high surface hydrophobicity of group A strains.     

Correlation between birth weight, leptin, zinc and copper levels in maternal and cord blood

Leptin and zinc are involved in the regulation of appetite. Copper is a trace element regulating the functions of several cuproenzymes that are essential for life. To evaluate the relationship between zinc and copper status and the leptin system in humans, we examined whether leptin concentrations in the mother and the newborn correlate with the weight of mother, placenta and newborn. A total of 88 pregnant women at 38-42 weeks' gestation were studied. All infants were categorized as small for gestational age (SGA) (n = 16), average for gestational age (AGA) (n = 59) or large for gestational age (LGA) (n = 13). Leptin, zinc, and copper levels were measured in maternal and cord serum at birth. Maternal BMI and placental weight of the LGA groups were significantly higher than those of the SGA and AGA groups. Cord and maternal leptin levels of the SGA groups were significantly lower than those of the AGA and LGA groups. Maternal serum leptin levels were positively correlated with BMI and maternal zinc levels in all groups. Cord serum leptin levels of all groups were positively correlated with birth weight and placental weight. Birth weight was negatively correlated with maternal and cord copper level of all groups. Umbilical leptin concentrations of SGA newborns correlated with leptin concentrations of their mothers. In all pregnancies, birth weight increases in association with increase in cord leptin level. Our results suggest that maternal zinc but not copper level has an effect on maternal serum leptin levels. The increase in copper level in both maternal and cord blood may contribute to restriction in fetal growth.     

A new method for the rapid diagnosis of acute streptococcal infection]

The work deals with the development of the rapid method of the identification of acute streptococcal infection on the basis of the coagglutination test. The rapid method of the extraction of group-specific polysaccharide antigen from the cell walls of group A streptococci is proposed. The data on the use of native sera and their fractions in the development of coagglutination diagnostica have been described and analyzed. The advantages of the new method of the diagnosis of acute streptococcal infection in comparison with the traditional microbiological method are shown.     

Molecular genetic diversity of musk deer Moschus moschiferus L., 1758 (Ruminantia, Artiodactyla) from the northern subspecies group

Genetic diversity within the northern subspecies group of musk deer Moschus moschiferus L, 1758 was examined based on the mtDNA control region hypervariable fragment (300-bp) sequence polymorphism. Nucleotide diversity, constituting 2.6% for the whole sample (n = 34), varied in the range from 0.6 to 1.9% for individual subspecies. Maximum values of this index were observed for Siberian subspecies (M. m. moschiferus), which had the widest range. Genetic similarity between the haplotypes of the musk deer from the Far East (Russia) and Sakhalin Island, which grouped in one cluster in a phylogenetic tree, was demonstrated. The data obtained indicate that the distribution of musk deer along the territory of Russia occurred from Eastern Siberia to the Far East, and from there to the Sakhalin Island. A currently observed decrease of the musk deer population number along with the increased habitat fragmentation can result in a decrease of the total genetic diversity and in inbreeding depression in the local isolated groups.     

Insulin-like growth factors and their binding proteins in children born small for gestational age: implication for growth hormone therapy

The insulin-like growth factors (IGFs) and their binding proteins (IGFBPs) are important regulators of growth and metabolism and are the key mediators of the actions of growth hormone (GH). Children born small for gestational age (SGA) have a host of medical problems including an increased risk of poor growth later in life, a tendency to develop metabolic abnormalities and a high incidence of learning disabilities. IGFs and related molecules may be linked to all of these concerns. Mouse models of IGF-I and IGF-II deficiencies have phenotypes reminiscent of human SGA, including slow growth, insulin resistance, and mental dysfunction. Humans with IGF-I mutations are born SGA and exhibit very poor subsequent growth, metabolic syndrome and mental retardation. Current management of children born SGA who present with growth failure during childhood includes treatment with GH. SGA children usually have growth factor levels within the normal range; however, as a group, they display lower IGFBP-3 levels in relation to their IGF-I levels. GH is effective in improving growth in children born SGA, but higher doses of GH are required to achieve optimal outcome, suggesting a component of GH insensitivity in SGA children. As in other indications for GH, a rational monitoring approach (focusing on maintaining IGF levels in the high normal range) is prudent.     

Risk Factors and Adverse Perinatal Outcomes among Term and Preterm Infants Born Small-for-Gestational-Age: Secondary Analyses of the WHO Multi-Country Survey on Maternal and Newborn Health

Background

Small for gestational age (SGA) is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes among twenty-nine countries in Africa, Latin America, the Middle East and Asia in 359 health facilities in 2010–11.

Methods

We analysed facility-based, cross-sectional data from the WHO Multi-country Survey on Maternal and Newborn Health. We constructed multilevel logistic regression models with random effects for facilities and countries to estimate the risk factors for SGA infants using country-specific birthweight reference standards in preterm and term delivery, and SGA’s association with adverse perinatal outcomes. We compared the risks and adverse perinatal outcomes with appropriate for gestational age (AGA) infants categorized by preterm and term delivery.

Results

A total of 295,829 singleton infants delivered were analysed. The overall prevalence of SGA was highest in Cambodia (18.8%), Nepal (17.9%), the Occupied Palestinian Territory (16.1%), and Japan (16.0%), while the lowest was observed in Afghanistan (4.8%), Uganda (6.6%) and Thailand (9.7%). The risk of preterm SGA infants was significantly higher among nulliparous mothers and mothers with chronic hypertension and preeclampsia/eclampsia (aOR: 2.89; 95% CI: 2.55–3.28) compared with AGA infants. Higher risks of term SGA were observed among sociodemographic factors and women with preeclampsia/eclampsia, anaemia and other medical conditions. Multiparity (> = 3) (AOR: 0.88; 95% CI: 0.83–0.92) was a protective factor for term SGA. The risk of perinatal mortality was significantly higher in preterm SGA deliveries in low to high HDI countries.

Conclusion

Preterm SGA is associated with medical conditions related to preeclampsia, but not with sociodemographic status. Term SGA is associated with sociodemographic status and various medical conditions.