Intrauterin Growth Restriction (IUGR)

Intrauterine Growth Restriction (IUGR)
= condition where the fetus is smaller than expected for the number of weeks of
pregnancy (small for gestational age)
- estimated fetal weight less than the 10th percentile
- may be born at term (after 37 weeks of pregnancy) or prematurely (before 37 weeks)
- babies often appear thin, pale, and have loose dry skin.
umbilical cord is often thin and dull-looking rather than shiny and fat.
hypoglycaemia, hypothermia, polycythemia

Causes:
- occurs when a problem or abnormality prevents cells and tissues from growing or
causes cell to decrease in size.
- due to fetus not receiving the necessary nutrients and oxygen needed for growth and
development of organs and tissues, or because of infection.
• Maternal factors:
o high blood pressure
o chronic kidney disease
o advanced diabetes
o heart or respiratory disease
o hypoxemia (high altitude, cyanotic cardiac, pulmonary disease)
o malnutrition, anemia
o infection
o substance abuse (alcohol, drugs)
o cigarette smoking
• Factors involving the uterus and placenta:
o decreased blood flow in the uterus and placenta
o decrease in surface area, infarction
o decreased placental weight or cellularity or both
o placental abruption (placenta detaches from the uterus)
o placenta previa (placenta attaches low in the uterus)
o tumour (chorioangioma, hydatiform mole)
o infection in the tissues around the fetus
• Factors related to the developing baby (fetus):
o multiple gestation (twins, triplets, etc.)
o infection (CMV, Rubella, Syphilis, Toxoplasmosis)
o birth defects (congenital heart defect, diaphragmatic hernia)
o chromosomal abnormality (Trisomy 21 & 18)
o radiation
o familial and racial background
http://pediatrics.aappublications.org/cgi/content/full/112/1/150

(Posted by: Vivian)