Title: A Brief Review of Hyperinsulinism in Small for Gestational Age Infants
Authors: Jogender Kumar MD, Amitabh Singh MD
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.29
Abstract
Introduction
Small for gestational age (SGA) neonates are classically defined as having a birth weight less than two standard deviations below the mean birth weight of specific gestational age or less than the 10th percentile of a population-specific birth weight for given gestational age. (1) SGA is a statistical definition and it is not synonymous with intrauterine growth restriction (IUGR). Fetuses with IUGR fail to reach their in utero growth potential; whereas neonates who are SGA are born less than a prespecified weight percentile regardless of the etiology. (2) According to WHO 2013 statistics globally 27% of all live births are SGA and out of all of these babies two- third are born in South East Asia. India has the largest number of SGA babies worldwide with a prevalence of 46.9 %. (3) Hypoglycemia is quite common in babies with the incidence ranging from 27-52%. In this population, 98% of hypoglycemic episodes occur in the first 24 hours. (4) This signifies that in the first two days these babies are at maximum risk of hypoglycemia. The most common etiology for hypoglycemia in this subgroup is suboptimal glycogen and fat stores, delayed appearance of Gluconeogenic enzymes and Hyperinsulinism. The incidence of Hyperinsulinism in SGA babies varies from 10-94% (4-7).
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