NEUROLOGICAL MANIFESTATIONS IN TERM SMALL-FOR-GESTATIONAL-AGE INFANTS: AN ALGORITHM FOR EARLY DIAGNOSIS (Literature Review)

Аннотация

The article presents a comprehensive analysis of the problem of neurological disorders in term small-for-gestational-age (SGA) infants, a group at high risk for adverse outcomes. The pathogenetic mechanisms of central nervous system (CNS) damage are examined, including placental insufficiency, hypoxia, nutritional deprivation, excitotoxicity, oxidative stress, and epigenetic modifications. The spectrum of clinical manifestations is described, ranging from acute neonatal syndromes to long-term consequences (cognitive deficits, cerebral palsy (CP), ADHD, ASD, epilepsy). Risk factors are systematized, and a scientifically grounded algorithm for early comprehensive diagnostics is proposed, incorporating prenatal monitoring, neonatal assessment (neurosonography (NSG), amplitude-integrated EEG (aEEG)/EEG, scales), advanced methods (MRI, evoked potentials (EP), genetic testing), and dynamic observation. The necessity of a multidisciplinary approach and continuous rehabilitation for SGA infants from the prenatal period through school age is substantiated. It is emphasized that early diagnosis and timely initiation of an individualized rehabilitation program are key factors for improving the neurological prognosis and quality of life in this vulnerable patient group. The work is based on the analysis of current literature data and clinical guidelines.