Current Concepts in Intrauterine Growth Restriction
- 1 November 2004
- journal article
- review article
- Published by SAGE Publications in Journal of Intensive Care Medicine
- Vol. 19 (6), 307-319
- https://doi.org/10.1177/0885066604269663
Abstract
Regulation of fetal growth is multifactorial and complex. Diverse factors, including intrinsic fetal conditions as well as maternal and environmental factors, can lead to intrauterine growth restriction (IUGR). The interaction of these factors governs the partitioning of nutrients and rate of fetal cellular proliferation and maturation. Although IUGR is probably a physiologic adaptive response to various stimuli, it is associated with distinct short- and long-term morbidities. Immediate morbidities include those associated with prematurity and inadequate nutrient reserve, while childhood morbidities relate to impaired maturation and disrupted organ development. Potential long-term effects of IUGR are debated and explained by the fetal programming hypothesis. In formulating a comprehensive approach to the management and follow-up of the growth-restricted fetus and infant, physicians should take into consideration the etiology, timing, and severity of IUGR. In addition, they should be cognizant of the immediate perinatal response of the growth-restricted infant as well as the childhood and long-term associated morbidities. A multi disciplinary approach is imperative, including early recognition and obstetrical management of IUGR, assessment of the growth-restricted newborn in the delivery room, possible monitoring in the neonatal intensive care unit, and appropriate pediatric follow-up. Future research is necessary to establish effective preventive, diagnostic, and therapeutic strategies for IUGR, perhaps affecting the health of future generations.This publication has 100 references indexed in Scilit:
- For Debate: Fetal and early postnatal growth restriction lead to diabetes, the metabolic syndrome and renal failure*Diabetologia, 2003
- Assessment of stillbirth risk and associated risk factors in a tertiary hospitalJournal of Obstetrics and Gynaecology, 2002
- Prenatal programming of adult hypertension in the ratKidney International, 2001
- Intrauterine growth retardation, general movements, and neurodevelopmental outcome: a reviewDevelopmental Medicine and Child Neurology, 2001
- Effects Of Intra‐Uterine Growth Restriction On The Control Of Breathing And Lung Development After BirthClinical and Experimental Pharmacology and Physiology, 2000
- Effectiveness of Interventions to Prevent or Treat Impaired Fetal GrowthObstetrical & Gynecological Survey, 1997
- Effects of intrauterine growth retardation in premature infants on early childhood growthThe Journal of Pediatrics, 1997
- Seasonal changes in growth and energy status in the Third WorldProceedings of the Nutrition Society, 1994
- Growth and neurodevelopmental outcome of very low birth weight infants with intrauterine growth retardation: Comparison with control subjects matched by birth weight and gestational ageThe Journal of Pediatrics, 1993
- INFANT MORTALITY, CHILDHOOD NUTRITION, AND ISCHAEMIC HEART DISEASE IN ENGLAND AND WALESThe Lancet, 1986