An appropriate for gestational age (AGA) baby is one whose size falls within the normal range for their gestational age and sex. AGA babies tend to have the lowest health risks. Gestational age can be determined through physical and neurological criteria. Small for gestational age (SGA) refers to babies smaller than the 10th percentile, while large for gestational age (LGA) means greater than the 90th percentile. Factors that influence birth weight include genetics, infections, fetal growth issues, and maternal health behaviors and characteristics. Complications for SGA infants include respiratory issues and infections, while LGA babies face risks like shoulder dystocia and hypoglycemia. Gestational age and fetal growth are

1. Gestational
Age

2. An appropriate for
gestational age
AGA

3. a fetus or newborn infant whose size
is within the normal range for
height, weight, head size, and
developmental level for a child of
the same gestational age and
gender.
full-term infant is heavier than 2,5kg
(about 5.5 lbs.) and lighter than 4 kg
(about 8.75 lbs.).

5. • . The gestational age can be determined
by physical criteria & neurological
criteria according to estimated NBS
score…

6. • An AGA baby tends to have the lowest
risk for any problems. AGA babies have
lower rate of disease and death than
babies that are small or large for their
gestational age
• The mortality rate of full term babies is
0.69 per 1,000 live births.

7. The main cause of death:
congenital anomalies (64.5%), specifically
cardiac anomalies.
chromosomal anomalies or syndromes
(12.9%)
labor complications (12.9%)
infections (3.2%)
congenital diseases (3.2%) and
metabolic disorders (3.2%).

8. Small for gestational age
• Infant born at weight less than
the 10th percentile for age .
• low birth weight (LBW), an
infant with a weight less than
2500 g regardless of
gestational age at time of
birth.
• very low birth weight infants,
weighting less than 1500g .
• 6-7% of all births and 70% of
neonatal death

9. Causes
Genetic (down syndrome – renal agenesis – congenital heart disease )
Fetal rubella infection
reduce fetal production of insulin and insulin like growth factor
 IUGR is the most common cause
 Maternal factors associated with LBW caused by premature birth or
IUGR include :
 previous low birth weight
 low socioeconomic status
 low level of maternal education
 no antenatal care
 maternal age younger than 16years or older than 35years
 short interval between pregnancies
 cigarette smoking, alcohol and illicit drug use
 psychological stresses(poor social support)
 poor weight gain during pregnancy(less than10Ib)
 low prepregnancy weight(lessthan45kg)
 African-american women

10. complication
 Birth asphyxia .
 Respiratory distress syndrome .
 hypoglycemia.
 Failure-to-Thrive.
 Infection (sepsis, pneumonia, gastroenteritis )
 Jaundice
 Cardiac (PDA)
 Neurologic (hemorrhage , seizures )

11. Large for gestationel Age
 Infant born at weight greater than the 90th
percentile for age .
 Macrosomia confused with LGA .
 1 out of 10 women .

12. causes
 Gestational age; beyond 40 weeks
 Fetal sex; male infant
 Excessive maternal weight gain
 Multiparity (3 times risk than primparus )
 Congenital anomalies (transposition of great
vessels)
 Erythroblastosis fetalis - Hydrops fetalis
 Use antibiotics (amoxicillin, pivampicillin) during
pregnancy
 Genetic disorders of overgrowth (e.g. Beckwith–
Wiedemann syndrome, Sotos syndrome)

13. complication
Metrnal :
reason for an induction (16%), and for C-S(9%)
Child:
shoulder dystocia .
hypoglycemia .
Meconium aspiration syndrome .
Congenital heart disease .
3% risk for diabetes

14. Diagnosis
us Fundal height

15. Diagnosis
 Us
US not good informative about weight so cannot be
diagnosed until after birth .
 Fundal height
More than 2 cm larger than expected ….LGA
Less than 2 cm smaller than expected ….SGA
1 of 3 is accurate

16. Assessments for newborn
babies
1- Apgar score .
2- weight .
2- Ballard criteria .

17. Apgar score
Asses the need for resuscitation at intervals 1-5 minutes

18. Apgar score
 0 - 3
Cardiopulmonary arrest
Sever bradycardia , hypoventilation , CNS depression
 4 - 7
Close monitoring
 >8
normal

19. Weight
 Macrosomic . > 4000 g
 LBW . < 2500 g
 VLBW . < 1500 g
Must apply on chart .

20. Ear—The preterm infant’s ear cartilages are poorly developed,
and the ear may fold easily; the hair is fine and
feathery, and lanugo may cover the back and face. The
mature infant’s ear cartilages are well formed, and the
hair is more likely to form firm, separate strands.


21. Sole—The sole of the foot of the preterm infant appears
more turgid and may have only fine wrinkles. The mature
infant’s sole (foot) is well and deeply creased.


22. Female genitalia—The preterm female infant’s clitoris is
prominent, and labia majora are poorly developed and
gaping. The mature female infant’s labia majora are fully
developed, and the clitoris is not as prominent.


23. Male genitalia—The preterm male infant’s scrotum is undeveloped
and not pendulous; minimal rugae are present,
and the testes may be in the inguinal canals or in the abdominal
cavity. The term male infant’s scrotum is well
developed, pendulous, and rugated, and the testes are
well down in the scrotal sac.


24. Grasp reflex—The preterm infant’s grasp is weak; the
term infant’s grasp is strong, allowing the infant to be
lifted up from the mattress.
