Small for gestational age birth weight: impact on lung structure and function

Paediatr Respir Rev. 2013 Dec;14(4):256-62. doi: 10.1016/j.prrv.2012.10.001. Epub 2012 Nov 22.


Accumulating data suggest that prenatal compromises leading to intrauterine growth restriction (IUGR) increase the risk for respiratory deficiencies after birth. In this respect, a growing body of epidemiological evidence in infants, children and adults indicates that small for gestational (SGA) birth weight can adversely affect lung function, thus questioning the widely accepted concept that IUGR accelerates lung maturation and improves outcome. Although the mechanisms responsible for the relationship between SGA and later lung dysfunction remain poorly documented, animal data indicate that intrauterine lung development can be adversely affected by factors associated with IUGR, namely reduced substrate supply, fetal hypoxemia and hypercortisolemia. Thus, it is suggested that fetal adaptations to intrauterine undernutrition result in permanent changes in lung structure, which in turn lead to chronic airflow obstruction. The purpose of this review is to describe and discuss the effects of IUGR on lung structure and function.

Keywords: Chronic obstructive lung disease; Fetus; Respiratory distress syndrome; Respiratory function; Surfactant system.

Publication types

  • Review

MeSH terms

  • Birth Weight*
  • Gestational Age
  • Global Health
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Small for Gestational Age*
  • Lung / embryology*
  • Lung / physiopathology*
  • Respiration*
  • Respiratory Distress Syndrome, Newborn* / diagnosis
  • Respiratory Distress Syndrome, Newborn* / epidemiology
  • Respiratory Distress Syndrome, Newborn* / physiopathology

Supplementary concepts

  • Respiratory Distress Syndrome In Premature Infants