Organ size in small infants (The OSSI Study): are sonographic reference intervals applicable in preterm infants small for gestational age?
6 affiliations
- 1Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- 2Department of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- 3Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- 4Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- 5Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. [email protected].
- 6Department of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. [email protected].
Abstract
Sonographic reference intervals for liver, spleen, and kidney size in preterm infants below 40 cm body length were recently established in an appropriately grown (AGA) neonatal cohort. Whether these intervals apply to infants born small for gestational age (SGA) remains unexamined. In this cross-sectional study, 20 preterm SGA infants below 40 cm body length (mean gestational age 29 ¹/₇ weeks, median birth weight 695 g) underwent standardized abdominal ultrasound, measuring craniocaudal liver length in three planes, splenic length, and renal volume. Measurements were compared with published reference intervals, and z-scores assessed systematic deviation. Weight and length at examination were comparable between the SGA and AGA cohorts. The mean z-score was significantly below zero only for liver length in the midclavicular line (- 0.79, p = 0.014). The proportion of infants outside the reference interval exceeded the expected 5% for liver length in the midclavicular line (25%, p = 0.003) and anterior axillary line (20%, p = 0.016) and for spleen length (20%, p = 0.016), but rested on 4 to 5 infants each, and several values lay within 1 mm of the limit. Kidney measurements did not differ from the reference. Organ size correlated most strongly with body weight, and the deviations persisted at equal weight (post hoc).Conclusion
Abdominal organ dimensions in SGA preterm infants frequently fall outside AGA-derived reference intervals, particularly for liver and spleen size, suggesting that these intervals cannot be reliably applied to this population. Prospective studies establishing reference values for SGA infants are warranted.What is known
• Sonographic reference intervals for abdominal organ size in preterm infants below 40 cm exist only for appropriately grown (AGA) infants; their applicability to infants small for gestational age (SGA) has not been examined.What is new
• In 20 preterm SGA infants, the mean z-score for liver length (midclavicular line) was below the AGA reference, and liver and spleen lengths fell outside the intervals more often than the expected 5% (exploratory). • AGA intervals should not be assumed to apply to SGA infants.
Related
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- Correlation between physical growth and neurodevelopmental outcomes in full-term small for gestational age infants within the first 2 years of life.
- Dental caries incidence in infants with abnormal birth weight for gestational age: a longitudinal study in the Japan Environment and Children’s Study
- Elevated Maternal Glycated Albumin is Associated with Large for Gestational Age Infants: Results from a Prospective Longitudinal Study
BibTeX
@article{klischke2026organ,
title = {{Organ size in small infants (The OSSI Study): are sonographic reference intervals applicable in preterm infants small for gestational age?}},
author = {Lara Klischke and Diane Miriam Renz and Thomas Müller and Lars Brodowski and Doris Franke and Alexandros Rahn},
journal = {European journal of pediatrics},
year = {2026},
month = oct,
doi = {10.1007/s00431-026-07580-4},
url = {https://europepmc.org/article/MED/42955401},
note = {CC BY},
}
RIS
TY - JOUR
TI - Organ size in small infants (The OSSI Study): are sonographic reference intervals applicable in preterm infants small for gestational age?
AU - Lara Klischke
AU - Diane Miriam Renz
AU - Thomas Müller
AU - Lars Brodowski
AU - Doris Franke
AU - Alexandros Rahn
PY - 2026
DA - 2026/10/28
JO - European journal of pediatrics
DO - 10.1007/s00431-026-07580-4
UR - https://europepmc.org/article/MED/42955401
AB - Sonographic reference intervals for liver, spleen, and kidney size in preterm infants below 40 cm body length were recently established in an appropriately grown (AGA) neonatal cohort. Whether these intervals apply to infants born small for gestational age (SGA) remains unexamined. In this cross-sectional study, 20 preterm SGA infants below 40 cm body length (mean gestational age 29 ¹/₇ weeks, median birth weight 695 g) underwent standardized abdominal ultrasound, measuring craniocaudal liver length in three planes, splenic length, and renal volume. Measurements were compared with published reference intervals, and z-scores assessed systematic deviation. Weight and length at examination were comparable between the SGA and AGA cohorts. The mean z-score was significantly below zero only for liver length in the midclavicular line (- 0.79, p = 0.014). The proportion of infants outside the reference interval exceeded the expected 5% for liver length in the midclavicular line (25%, p = 0.003) and anterior axillary line (20%, p = 0.016) and for spleen length (20%, p = 0.016), but rested on 4 to 5 infants each, and several values lay within 1 mm of the limit. Kidney measurements did not differ from the reference. Organ size correlated most strongly with body weight, and the deviations persisted at equal weight (post hoc).Conclusion Abdominal organ dimensions in SGA preterm infants frequently fall outside AGA-derived reference intervals, particularly for liver and spleen size, suggesting that these intervals cannot be reliably applied to this population. Prospective studies establishing reference values for SGA infants are warranted.What is known • Sonographic reference intervals for abdominal organ size in preterm infants below 40 cm exist only for appropriately grown (AGA) infants; their applicability to infants small for gestational age (SGA) has not been examined.What is new • In 20 preterm SGA infants, the mean z-score for liver length (midclavicular line) was below the AGA reference, and liver and spleen lengths fell outside the intervals more often than the expected 5% (exploratory). • AGA intervals should not be assumed to apply to SGA infants.
SN - 0340-6199
SN - 1432-1076
ER -