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Small and growth‐restricted babies: Drawing the distinction

The terms “small for gestational age” and “intrauterine growth restriction” have been used interchangeably to denote an in utero growth‐restricted neonate. However, the two terms are not synonymous; not all small babies are growth restricted and not all growth‐restricted ones are small. Research evidence, extending back to the middle of the last century, reveals that the number of growth‐restricted babies who escape attention is not negligible and that the postnatal outcome of these babies is not uneventful. This paper highlights this issue and further discusses the available diagnostic tools for the identification of in utero‐restricted neonates, that is, clinical assessment, anthropometric indices and obstetric ultrasound. Each of these tools has strengths and limitations, but, if combined, each could complement the other and help differentiate well‐grown babies from those who are growth restricted.