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. 2025 Jul 16;25(1):763.
doi: 10.1186/s12884-025-07870-z.

The criteria to classify body-proportionality of the small for gestational age newborn: a scoping review

Aziz Berkay Karadavut  1 , Ilke Smits  1 , Jeroen van Dillen  2   3 , Marije Hogeveen  1
Affiliations

The criteria to classify body-proportionality of the small for gestational age newborn: a scoping review

Aziz Berkay Karadavut et al. BMC Pregnancy Childbirth. .

Abstract

Purpose: To create an overview of the criteria used to classify small for gestational age (SGA) newborns according to their body-proportionality as either asymmetric SGA or symmetric SGA, and to create an overview of the clinical outcomes related to body-proportionality.

Methods: A scoping review was conducted using PubMed, Embase and the Cochrane Library databases. Studies were included if they described SGA newborns regardless of gestational age and if their classification on body-proportionality was given for both aSGA and sSGA. Data were screened and extracted by two independent reviewers.

Results: Of the 38,265 studies identified after deduplication, 45 were included. Body-proportionality was classified by the ponderal index (PI) in 55.6% of studies (n = 25), head circumference (HC) in 24.4% (n = 11), birth length in 11.1% (n = 5), birth length and HC in 4.4% (n = 2), birth length and PI in 2.2% (n = 1), and PI, brain-to-body ratio and HC/length ratio in 2.2% (n = 1). The most commonly reported outcomes were asphyxia, hyperbilirubinemia, hypoglycemia, mortality and respiratory distress syndrome. The results regarding the outcomes were inconsistent and contradictory.

Conclusion: Large heterogeneity in the published classifications and clinical outcomes regarding body-proportionality in the SGA newborns exists. Consensus on terms, methods and cut-off values used for body-proportionality is needed to improve future comparison of study results.

Keywords: Asymmetry; Birth weight; Disproportionate; Neonate; Small for gestational age.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the selection process (conform PRISMA 2020)
See this image and copyright information in PMC

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