Is Being Born Small for Gestational Age a Lifelong Health Risk?

[Cobul]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608552/

Do you think this is already 100% accepted by the medical and scientific world? It says that if you are born Small for Gestational Age. You would get all kinds of diseases like diabetes, hypertension, coronary diseases, mental diseases etc when you get older. SGA means someone less than 5.5 pounds at birth. Is there an exception? Do you know someone born small and still normal at say 40 years old? Or are you forever doomed?

And is there no intervention that can invented to deprogram it? This should be one of the priority in medicine progress now.

 

[jedishrfu]

There is no 100% certainty in medicine.

If they say studies show that those born with low weight will have X then they qualify their statements by the statistical study they ran or by saying there is a higher incidence of X occurring in low weight babies.

So if you're not doomed now, but you fit the profile then you have a higher chance of getting it than other people. This means its good to have regular physicials and let your doctor check for X.

 

[jim mcnamara]

You need to understand CLEARLY: association is not causation

Absurd example: In the US electric carving knives came on the market the same year checkerboard ice cream became available. Observed fact. AFAIK it is actually correct.

Bad conclusion: Electric carving knives were developed to slice and serve checkerboard ice cream.

The concept in the paper is an observation like:

Average age at  death is lower:
  for humans who fall the 5th percentile and lower for height or weight
  for humans who fall the 95th percentile  and higher  for height or eight
  for BMI too high (>95%) or too low (<5%) also is a warning flag.

The function of the paper is to make student physicians aware of what those observations may imply for a patient, and do something. It is why elementary school kids of get height and weight screening. Kids often do not have defacto access to physicians,

It is a medical observation. So physicians try to intervene in favor of longevity. They check all kinds of marker serum proteins and hormone levels to find any kind of underlying pathology. And then try to improve things.

The same thing applies to US car insurance cost being based on the driver's age. Just because you are 16 years old does not mean you automatically will have a bad traffic accident.

 

[Tsu Dho Nimh]

Is there an exception? Do you know someone born small and still normal at say 40 years old? Or are you forever doomed?

My father, who was a healthy 6-foot tall adult, US Navy in WWII, and died at 85. None of those chronic health problems.
Me, currently over 70 and obviously still alive. Above average height for a woman, nothing chronic like the article lists.
A niece, currently late 30s, still very petite but so is her mother, grandmother and maternal aunts.

We were all 3.5 lb or less at birth.

The question is WHY are the newbotns small? If malnutrition, maternal smoking, or other maternal health issues affected the fetal growth, that's not good.

But some newborns are just small ... they eat well, they have good Apgar scores, they gain weight, they develop normally. It's not a declaration of doom.

 

[jim mcnamara]

Apgar scores are neonatal health assesments.

Usually, a timer is set at birth and the newborn is evaluated at one minute and then at 5 minutes. Apgar scoring is a generally a helpful indicator for possible problems, and not a final verdict on life or longevity. Obviously, if the newborn is delivered in the back of a taxi cab en route to the hospital this assessment will very likely not happen.

How this is done and an explanation (for non-medical people) of what the assessments involve:
https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Apgar-Scores.aspx

 

[Cobul]

My father, who was a healthy 6-foot tall adult, US Navy in WWII, and died at 85. None of those chronic health problems.
Me, currently over 70 and obviously still alive. Above average height for a woman, nothing chronic like the article lists.
A niece, currently late 30s, still very petite but so is her mother, grandmother and maternal aunts.

We were all 3.5 lb or less at birth.

The question is WHY are the newbotns small? If malnutrition, maternal smoking, or other maternal health issues affected the fetal growth, that's not good.

But some newborns are just small ... they eat well, they have good Apgar scores, they gain weight, they develop normally. It's not a declaration of doom.

What month were you born at 3.5 lbs? If it was 7 months, then it is right for gestational age. But if it was 9 months or term. And the reason was famine or insufficient nutrition, the findings was there your body would remodel so that the organs would only be optimum is there is also less food eaten when outside the womb. So if your diet from birth to 70 years old just very small quantities and not abundant like so full of calories, you would be fine. But if you eat abundantly like the rest, then hypertension, diabetes, coronary diseases would occur when you are at middle age. Didn't you or the relatives encountered this?

The paper and others offer so many experimental proof in animal and genetic studies. If true, we need to focus research on how to deprogram the epigenetic remodellng and reprogramming the fetal state when it was exposed to near famine conditions.

Also I'm suprised why others don't believe in this almost accepted findings. Are there really doctors who still don't believe in it?

To mentors who don't believe in it. Please don't lock this thread to avoid any discussions. Locking is only apparent victory, not real victory. Let us debate or discuss. In debate we can learn.

 

[Tsu Dho Nimh]

Full term, but none of the chronic problems. Also not the result of famine or malnutrition or maternal illness. Just born a lot smaller than average for unknown reasons.

Which is why I said that the reason for the low birth weight have to be considered before you can make any predictions about the future health of that newborn.

 

[Cobul]

Full term, but none of the chronic problems. Also not the result of famine or malnutrition or maternal illness. Just born a lot smaller than average for unknown reasons.

Which is why I said that the reason for the low birth weight have to be considered before you can make any predictions about the future health of that newborn.

Ok. What is average height of your family?

I read that if the small for gestational age babies got taller and bigger when adults, the risk factors would come out. If they remain small throughout life. Then no problem.

In China. Average height could be 5'4". Are you 5" or 5'4"?

This reference is about cause from famine.

https://en.wikipedia.org/wiki/Fetal_origins_hypothesis#Epidemiological_and_epigenetic_support

"Hunger winter
During World War II, a Nazi barricade resulted in a severe famine in the Western Netherlands. Where food was previously plentiful, supplies immediately were cut off in November 1944, resulting in a period of starvation that lasted until spring of 1945. The Dutch people survived on as little as 30% of their daily needed caloric intake, and tens of thousands of people died. Analyses of the orderly health records from this time period allow for a systematic comparison of the effects of fetal starvation. Individuals who were in utero during the Hunger Winter were subject to different outcomes depending on the period of time in which they were conceived. Those who were in the first trimester during the three-month siege were likely to be born normal size, having caught up with typical development. However, these normal size babies developed high blood pressure, diabetes, and obesity. Contrary to this group, those who were in the third trimester during the siege, who presumably had been well nourished up until the last few months of gestation, were born small. But, these small babies stayed small their entire lives, and did not develop higher rates of obesity or disease. Surprisingly, effects continued to be seen in the offspring of the individuals who were fetuses at the time of the famine."

 

[Tsu Dho Nimh]

Ok. What is average height of your family?​

I read that if the small for gestational age babies got taller and bigger when adults, the risk factors would come out. If they remain small throughout life. Then no problem. ​

In China. Average height could be 5'4". Are you 5" or 5'4"​

Very variable, mostly tall, even for USA standards. My dad was 6'0". My sisters both 5' 10"; my brother 6'3" and me - only 5'6" (my mom's family is much shorter - even the men were only 5'5" or so. I'm taller than most of them). Nephews - 6'4 and 6'6" (really tall!)

No famine or malnutrition involved, therefore few or low risks.

​

 

[Cobul]

Ok. What is average height of your family?​

I read that if the small for gestational age babies got taller and bigger when adults, the risk factors would come out. If they remain small throughout life. Then no problem. ​

In China. Average height could be 5'4". Are you 5" or 5'4"​

Very variable, mostly tall, even for USA standards. My dad was 6'0". My sisters both 5' 10"; my brother 6'3" and me - only 5'6" (my mom's family is much shorter - even the men were only 5'5" or so. I'm taller than most of them). Nephews - 6'4 and 6'6" (really tall!)

No famine or malnutrition involved, therefore few or low risks.

​

Thanks for sharing this. So there are SGA (Small for Gestational Age) babies whose cause is genetic and no pathological problems. I read:

https://www.aafp.org/afp/1998/0801/p453.html

"Classification and Etiology

IUGR is the pathologic counterpart of small-for-gestational-age. The latter includes fetuses that are small but have reached their appropriate growth potential. Many babies are simply genetically small and are otherwise normal.1 Some women have a tendency to have constitutionally small babies. Although both parents' genes affect childhood growth and final adult size, maternal genes mainly influence birth weight.3,4 Parity, age and socioeconomic status are intercorrelated and may also influence the pregnancy and the infant's birth weight. Table 1 summarizes clinical situations in which IUGR may occur."

Do you know what ethnic groups have newborn weighting less than 4 lbs like you? Or is this random in the population?