Management of infants with intra-uterine growth restriction.

Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
The Indian Journal of Pediatrics (Impact Factor: 0.72). 02/2008; 75(2):171-4. DOI: 10.1007/s12098-008-0025-6
Source: PubMed

ABSTRACT Intra-uterine growth restriction (IUGR) contributes to almost two-thirds of LBW infants born in India. Poor nutritional status and frequent pregnancies are common pre-disposing conditions in addition to obstetric and medical problems during pregnancy. Growth restriction may be symmetrical or asymmetrical depending on the time of insult during pregnancy. The pathological insult in an asymmetrical IUGR occurs during the later part of the pregnancy and has a brain-sparing effect. Common morbidities are more frequent in < 3rd percentile group as compared to 3rd-10th percentile group. Guidelines for management of IUGR neonates in these two groups have been provided in the protocol.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Intrauterine growth retardation (IUGR), the most important cause of perinatal mortality and morbidity, is defined as a foetal growth less than normal for the population, often used as synonym of small for gestational age (SGA). Studies demonstrated the relationships between metabolic syndrome (MS) and birthweight. This study suggested that, in children, adolescents, and adults born SGA, insulin resistance could lead to other metabolic disorders: type 2 diabetes (DM2), dyslipidemia, and nonalcoholic fatty liver disease (NAFLD). NAFLD may evolve to nonalcoholic steatohepatitis (NASH), and it is related to the development of MS. Lifestyle intervention, physical activity, and weight reduction represent the mainstay of NAFLD therapy. In particular, a catch-up growth reduction could decrease the risk to develop MS and NAFLD. In this paper, we outline clinical and experimental evidences of the association between IUGR, metabolic syndrome, insulin resistance, and NAFLD and discuss on a possible management to avoid the risk of MS in adulthood.
    International Journal of Endocrinology 11/2011; 2011:269853. DOI:10.1155/2011/269853 · 2.52 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Intrauterine growth restriction (IUGR) is defined as fetal growth less than the normal growth potential of a specific infant because of genetic or environmental factors. The terms IUGR and Small for Gestational Age (SGA) are often used alternatively to describe the same problem, although there exists subtle differences between the two. The burden of IUGR is concentrated mainly in Asia which accounts for nearly 75% of all affected infants. Various maternal, placental, neonatal, environmental and genetic factors are contributing to the preponderance of IUGR infants in Asia. These newborns are unique because of their peculiar and increased risk of immediate and long term complications in comparison with the appropriate gestational age born infants. In this review we would like to present the types of IUGR infants; possible etiology related to maternal, fetal and placental causes; short term and long term neurodevelopmental outcomes, and evidence based preventive interventions effective in reducing the IUGR burden. This review also highlights the genetic contribution of the mother to the fetus and the placenta in the genesis of unexplained or idiopathic intrauterine growth restriction.
    03/2014; 3(3). DOI:10.4172/2167-0897.1000135
  • [Show abstract] [Hide abstract]
    ABSTRACT: Small for gestational age (SGA) can occur following a pathological process or may represent constitutionally small fetuses. However, distinguishing these processes is often difficult, especially in large studies, where the term SGA is often used as a proxy for restricted fetal growth. Since biologic variation in fetal size is largely a third trimester phenomenon, we hypothesized that the definition of SGA at term may include a sizeable proportion of constitutionally small fetuses. In contrast, since biologic variation in fetal size is not fully expressed in (early) preterm gestations, it is plausible that SGA in early preterm gestations would comprise a large proportion of growth restricted fetuses. We compared mortality and morbidity rates between SGA and appropriate for gestational age (AGA) babies. A population-based study of over 19million non-malformed, singleton births (1995-04) in the United States was performed. Gestational age (24-44weeks) was based on a clinical estimate. SGA and AGA were defined as sex-specific birthweight <10th and 25-74th centiles, respectively, for gestational age. All analyses were adjusted for a variety of confounding factors. Excess mortality risk in SGA and AGA babies. On an additive scale, stillbirth and neonatal mortality rates were higher at every preterm gestation among SGA than AGA births, and similar at term gestations. An inverse relationship between gestational age and excess deaths between SGA and AGA babies delivered at <37weeks was evident. In early preterm gestations, the definition of SGA may well be justified as a proxy for IUGR. In contrast, SGA babies that are delivered at term are likely to be constitutionally small.
    Early human development 09/2009; 85(10):653-8. DOI:10.1016/j.earlhumdev.2009.09.004 · 2.12 Impact Factor


Available from