This International Consensus Guideline was developed by experts in the field of small for gestational age (SGA) of 10 pediatric endocrine societies worldwide. A consensus meeting was held and 1300 articles formed the basis for discussions. All experts voted about the strengths of the recommendations. The guideline gives new and clinically relevant insights into the etiology of short stature after SGA birth, including novel knowledge about (epi)genetic causes. Further, it presents long-term consequences of SGA birth and also reviews new treatment options, including treatment with gonadotropin-releasing hormone agonist (GnRHa) in addition to growth hormone (GH) treatment, as well as the metabolic and cardiovascular health of young adults born SGA after cessation of childhood GH treatment in comparison with appropriate control groups. To diagnose SGA, accurate anthropometry and use of national growth charts are recommended. Follow-up in early life is warranted and neurodevelopment evaluation in those at risk. Excessive postnatal weight gain should be avoided, as this is associated with an unfavorable cardiometabolic health profile in adulthood. Children born SGA with persistent short stature < -2.5 SDS at age 2 years or < -2 SDS at 3 to 4 years of age, should be referred for diagnostic workup. In case of dysmorphic features, major malformations, microcephaly, developmental delay, intellectual disability, and/or signs of skeletal dysplasia, genetic testing should be considered. Treatment with 0.033 to 0.067 mg GH/kg/day is recommended in case of persistent short stature at age of 3 to 4 years. Adding GnRHa treatment could be considered when short adult height is expected at pubertal onset. All young adults born SGA require counseling to adopt a healthy lifestyle.

中文翻译：

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小于胎龄儿国际共识指南：从婴儿期到成年早期的病因学和管理。

本国际共识指南由全球 10 个儿科内分泌学会的小于胎龄儿 (SGA) 领域的专家制定。召开了共识会议，1300 篇文章构成了讨论的基础。所有专家都对建议的强度进行了投票。该指南对 SGA 出生后身材矮小的病因学提供了新的和临床相关的见解，包括关于 (epi) 遗传原因的新知识。此外，它还介绍了 SGA 出生的长期后果，并回顾了新的治疗方案，包括除了生长激素 (GH) 治疗外还使用促性腺激素释放激素激动剂 (GnRHa) 治疗，以及年轻人的代谢和心血管健康与适当的对照组相比，停止儿童 GH 治疗后出生的 SGA。要诊断 SGA，建议使用准确的人体测量学和国家生长图表。有必要在生命早期进行随访，并对有风险的人进行神经发育评估。应避免产后体重过度增加，因为这与成年后不利的心脏代谢健康状况有关。出生为 SGA 且 2 岁时持续性矮身材 < -2.5 SDS 或 3 至 4 岁时 < -2 SDS 的儿童，应转诊进行诊断检查。如果出现畸形特征、严重畸形、小头畸形、发育迟缓、智力障碍和/或骨骼发育不良的迹象，则应考虑进行基因检测。如果 3 至 4 岁持续性矮小，建议使用 0.033 至 0.067 mg GH/kg/天进行治疗。当预计青春期开始时成年身高较矮时，可以考虑增加 GnRHa 治疗。