Intrauterine Growth Restriction (IUGR) and Complications on Future Developments

 

Intrauterine Growth Restriction (IUGR) is a condition when the fetus is growing at a slower rate than normal (Sharma et al., 2016), and it is often associated with low birth weight or small for gestational age (SGA). However, IUGR is not the same as SGA, even though the two terms are often used interchangeably (Sharma, 2016). SGA means the baby weight less than 10^th percentile, whereas IUGR means the baby shows features of malnutrition and in-utero growth retardation (Sharma, 2016). IUGR affects about 10% of pregnancies and can be caused by a variety of factors such as maternal factors (ex: maternal age, socioeconomic status, etc.,), fetal factors (ex: pregnant with twins or triplets, genetic syndromes, etc.,), placental factors (ex: infections, placental weight, etc.,), and genetics (Sharma, 2016). Diagnosis of IUGR can be more accurately determined if the provider knows the first day of the last menstrual period and by 3^rd-trimester ultrasounds (Intrauterine Growth Restriction, n.d.). Once diagnosed, IUGR pregnancies could be managed antenatally and monitor and during delivery (Sharma, 2016; Peleg et al., 1998).

Babies born with an IUGR or SGA or both are often at a higher risk for health problems that can carry later into adulthood (Sharma, 2016). Some short-term complications of IUGR include conditions related to the lungs (such as pulmonary hemorrhage and persistent pulmonary hypertension), the heart and the kidneys (Sharma, 2016). This is due to a redistribution of blood flow from other parts of the body to provide nutrients and oxygen for the brain (Tchirikov et al., 1998) (Yajnik, 2004). Due to this, IUGR babies also have lower muscle mass compared to babies who are appropriate for gestational age (AGA), and this reduction in muscle mass and strength carries into adulthood (Brown & Hay, 2016). Other long-term consequences of IUGR that carry into adulthood include hypertension, immune dysfunction, lung abnormalities, ischemic heart disease, etc., in addition to an increased risk for neurodevelopmental problems (Wang et al., 2016) (Sharma, 2016) such as poor reading and mathematics learning (Sharma, 2016).

Even though there are a lot of complications regarding IUGR, according to Cleveland Clinic, most fetuses diagnosed with IUGR are healthy and just need more monitoring during pregnancy. In addition, environmental factors can play important roles in the development of a child that carry consequences into adulthood. By providing your child with a healthy and safe environment to live and learn in, a child with IUGR can thrive and live happy like any other children.

Citations:

Brown, L. D., & Hay, W. W. (2016). Impact of placental insufficiency on fetal skeletal muscle growth. Molecular and Cellular Endocrinology, 435, 69–77. https://doi.org/10.1016/j.mce.2016.03.017

Intrauterine Growth Restriction: Causes, Symptoms & Treatment. (n.d.). Cleveland Clinic. Retrieved November 28, 2023, from https://my.clevelandclinic.org/health/diseases/24017-intrauterine-growth-restriction

Peleg, D., Kennedy, C. M., & Hunter, S. K. (1998). Intrauterine Growth Restriction: Identification and Management. American Family Physician, 58(2), 453–460.

Sharma, D., Shastri, S., & Sharma, P. (2016). Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clinical Medicine Insights. Pediatrics, 10, 67–83. https://doi.org/10.4137/CMPed.S40070

Tchirikov, M., Rybakowski, C., Hüneke, B., & Schröder, H. J. (1998). Blood flow through the ductus venosus in singleton and multifetal pregnancies and in fetuses with intrauterine growth retardation. American Journal of Obstetrics and Gynecology, 178(5), 943–949. https://doi.org/10.1016/s0002-9378(98)70528-9

Wang, Y., Fu, W., & Liu, J. (2016). Neurodevelopment in children with intrauterine growth restriction: Adverse effects and interventions. The Journal of Maternal-Fetal & Neonatal Medicine, 29(4), 660–668. https://doi.org/10.3109/14767058.2015.1015417

Yajnik, C. S. (2004). Obesity epidemic in India: Intrauterine origins? The Proceedings of the Nutrition Society, 63(3), 387–396. https://doi.org/10.1079/pns2004365