Small for gestational age (SGA) neonates have an increased risk of obesity, diabetes mellitus, and glucose intolerance in adult life. Understanding the factors that can increase the risk of SGA and complications might help with management. Hence, we quantified the cellular parameters, random blood sugar (RBS), and insulin-like growth factor (IGF)-axis proteins in appropriate for gestational age (AGA) (n = 40) and SGA (n = 20) neonates cord blood samples. Cord blood cell parameters and RBS were measured using an automated analyzer; insulin-like growth factor 1 (IGF1) and insulin-like growth factor binding protein 2 (IGFBP2) proteins were measured using enzyme-linked immunosorbent assay (ELISA). Mean % hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red blood cell distribution width (RDW), packed cell volume (PCV), MCH concentration (MCHC), white blood cells (WBC), basophils, neutrophils, monocytes, lymphocytes, and RBS did not alter between AGA and SGA, except an increased red blood cells (RBC) (P = .034) and platelet (P = .025), and decreased eosinophils (P = .037). The cord blood plasma IGF1 did not differ (P = .79), and insulin-like growth factor binding protein 2 (IGFBP2) was significantly higher (P = .04) in SGA. Overall, the RBC, platelets and IGFBP2 proteins were increased, and eosinophils were reduced in SGA neonates.
Díez LópezI, CernadaM, GalánL, BoixH, IbañezL, CouceML.Small for gestational age: Concept, diagnosis and neonatal characterization, follow-up and recommendations. An Pediatr. 2024;101(2):124–131.
2.
ChoWK, SuhBK.Catch-up growth and catch-up fat in children born small for gestational age. Korean J Pediatr. 2016;59(1):1–7.
3.
Vinay SSG, KK, ShrivastavaA.Prevalence of small for gestational age term neonates and its surrogate marker. Int J Contemp Pediatr. 2019;6(3):1247–1250.
4.
OsuchukwuOO, ReedDJ.Small for gestational age (archived). StatPearls. Treasure Island (FL): StatPearls Publishing LLC; 2025.
5.
KatzJ, WuLA, MullanyLC, . Prevalence of small-for-gestational-age and its mortality risk varies by choice of birth-weight-for-gestation reference population. PLoS One. 2014;9(3):e92074.
6.
SharmaD, ShastriS, SharmaP.Intrauterine growth restriction: Antenatal and postnatal aspects. Clin Med Insights Pediatr. 2016. doi:10.4137/CMPed.S40070
7.
NieuwenhuijsenMJ, DadvandP, GrellierJ, MartinezD, VrijheidM.Environmental risk factors of pregnancy outcomes: A summary of recent meta-analyses of epidemiological studies. Environ Health. 2013;12:1–10.
8.
SchetterCD, TannerL.Anxiety, depression and stress in pregnancy: Implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012;25(2):141–148.
9.
SebastianT, YadavB, JeyaseelanL, VijayaselviR, JoseR.Small for gestational age births among South Indian women: Temporal trend and risk factors from 1996 to 2010. BMC Pregnancy Childbirth. 2015;15:1–10.
10.
KumarS, SharmaA, KshetrimayumC.Environmental & occupational exposure & female reproductive dysfunction. Indian J Med Res. 2019;150(6):532–545.
11.
OrtegaMA, Fraile-MartínezO, García-MonteroC, . Unfolding the role of placental-derived extracellular vesicles in pregnancy: From homeostasis to pathophysiology. Front Cell Dev Biol. 2022;10:1060850.
12.
GarnicaAD, ChanW-Y.The role of the placenta in fetal nutrition and growth. J Am Coll Nutr. 1996;15(3):206–222.
13.
ElgariMM, WaggiallahHA.Assessment of hematological parameters of neonatal cord blood in anemic and non-anemic mothers. J Clin Exp Res. 2013;1(2):22–25.
14.
RolimACB, LambertMA, BorgesJPG, . Blood cells profile in umbilical cord of late preterm and term newborns. Rev Paul Pediatr. 2019;37(3):264–274.
15.
OkuyamaT, KyoharaM, TerauchiY, ShirakawaJ.The roles of the IGF axis in the regulation of the metabolism: Interaction and difference between insulin receptor signaling and IGF-I receptor signaling. Int J Mol Sci. 2021;22(13):6817.
16.
NithyaM, KrishnappaJ, SheelaS, RaaviV.Alteration in the levels of IGF-axis components in small for gestational age neonates. Gene Rep. 2024;35:101891.
17.
YalinbasEE, BinayC, SimsekE, AksitMA.The role of umbilical cord blood concentration of IGF-I, IGF-II, leptin, adiponectin, ghrelin, resistin, and visfatin in fetal growth. Am J Perinatol. 2019;36(6):600–608.
18.
MNN, RaaviV.The role of insulin-like growth factor-axis and mitotic index in South Indian neonates with small for gestational age. Fetal Pediatr Pathol. 2023;42(2):216–226.
19.
ArgyrakiM, DamdimopoulouP, ChatzimeletiouK, . In-utero stress and mode of conception: Impact on regulation of imprinted genes, fetal development and future health. Hum Reprod Update. 2019;25(6):777–801.
20.
JoshiNP, ManeAR, SahayAS, SundraniDP, JoshiSR, YajnikCS.Role of placental glucose transporters in determining fetal growth. Reprod Sci. 2022;29:1–16.
21.
WasilukA, DabrowskaM, OsadaJ, JasinskaE, LaudanskiT, RedzkoS.Platelet indices in SGA newborns. Adv Med Sci. 2011;56(2):361–365.
22.
MannaS, DharI, NaskarT, LawS.Cord blood haematological parameters reference range difference in urban and rural population of West Bengal as compared to global scenario. J Biomed Res Environ Sci. 2021;2(3):206–212.
23.
RonchiF, PorcellaA, PorcuPP, . Cord blood hematological reference values in term and late preterm infants from the Mediterranean island of Sardinia: A preliminary study. J Pediatr Neonatal Individ Med. 2021;10(1):e100109.
24.
DemirMB, AkM, ÇamŞD, CündübeyCR.Evaluation of umbilical cord blood hematological parameters in pregnant women with fetal growth restriction. Eur Res J. 2023;9(4):817–822.
25.
TanriverdiS, CetinE.Comparison of glucose and lipid values in cord blood of newborns with small, normal and large birth weight according to gestational age. Ann Med Res. 2022;29(8):802–808.
26.
Martínez-CorderoC, Amador-LiconaN, Guízar-MendozaJM, Hernández-MéndezJ, Ruelas-OrozcoG.Body fat at birth and cord blood levels of insulin, adiponectin, leptin, and insulin-like growth factor-I in small-for-gestational-age infants. Arch Med Res. 2006;37(4):490–494.
27.
NawatheAR, ChristianM, KimSH, JohnsonM, SavvidouMD, TerzidouV.Insulin-like growth factor axis in pregnancies affected by fetal growth disorders. Clin Epigenetics. 2016;8:1–13.
28.
IniguezG, GonzalezC, ArgandonaF, KakariekaE, JohnsonM, CassorlaF.Expression and protein content of IGF-I and IGF-I receptor in placentas from small, adequate and large for gestational age newborns. Horm Res Paediatr. 2010;73(5):320–327.
29.
De KortSW, SandraWK, van DoornJ, van de SandeAG, LeunissenRW, Hokken-KoelegaAC.Serum insulin-like growth factor-binding protein-2 levels and metabolic and cardiovascular risk factors in young adults and children born small for gestational age. J Clin Endocrinol Metab. 2010;95(2):864–871.
30.
Rotshenker-OlshinkaK, ShinwellES, Juster-ReicherA, RosinI, Flidel-RimonO.Comparison of hematologic indices and markers of infection in umbilical cord and neonatal blood. J Matern Fetal Neonatal Med. 2014;27(6):625–628.
