Intrauterine growth restriction Health Article

Definition

Intrauterine growth restriction refers to the poor growth of a baby while in the womb. Specifically, it refers to a fetus whose weight is below the 10th percentile for its gestational age.

Alternative Names

Intrauterine growth retardation; IUGR

Causes, incidence, and risk factors

Many different things can lead to intrauterine growth restriction (IUGR). An unborn baby may not get enough nutrition because of:

• Heart disease in the mother
• High altitudes
• Multiple pregnancies (twins, triplets, etc.)
• Placenta problems
• Preeclampsia or eclampsia

Congenital or chromosomal abnormalities are often associated with below-normal weight. Infections during pregnancy that affect the fetus, such as rubella, cytomegalovirus, toxoplasmosis, and syphilis may also affect the weight of the developing baby.

Risk factors in the mother that may contribute to IUGR include:

• Alcohol abuse
• Drug addiction
• High blood pressure or heart disease
• Poor nutrition
• Smoking

If the mother is small, it may be normal for her to have a small fetus, but this is not due to IUGR.

Depending on the cause of IUGR, the fetus may be symmetrically small, or have a head that is normal size for gestational age, while the remainder of the fetus is growth restricted.

Symptoms

• Currently pregnant with a feeling that the baby is not as big as it should be
• Uterine fundal height less than expected for gestational age

Signs and tests

Intrauterine growth restriction (IUGR) may be suspected if the size of the pregnant woman's uterus is small. The condition is usually confirmed by ultrasound.

Further tests may be needed to screen for infection or genetic problems if IUGR is suspected.

Treatment

IUGR increases the risk for intrauterine death. If this condition is suspected, the pregnant woman will be closely monitored with several pregnancy ultrasounds to measure the baby's growth, movements, blood flow, and fluid around the baby. Non-stress testing will also be done. Depending on the results of these tests, delivery may be necessary.

Expectations (prognosis)

The prognosis for normal newborn growth and development varies by the degree and cause of IUGR. Prognosis should be discussed with your obstetrician and pediatrician.

Complications

Depending on the specific cause, IUGR increases the risk for a variety of pregnancy and newborn complications. Infants may have a non-reassuring fetal heart rate during labor, requiring delivery by c-section.