Abnormal fetal growth: intrauterine growth retardation, small for gestational age, large for gestational age

2004 ◽  
Vol 51 (3) ◽  
pp. 639-654 ◽  
Author(s):  
Utpala (“Shonu”) G Das ◽  
Gregory D Sysyn
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Small For Gestational Age ◽  
Intrauterine Growth Retardation ◽  
Large For Gestational Age ◽  
Intrauterine Growth

Categories of intrauterine growth retardation

1993 ◽  
Vol 5 (4) ◽  
pp. 203-212 ◽  
Author(s):  
Roger A Fay ◽  
David A Ellwood
Keyword(s):  
Soft Tissue ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Large Scale ◽  
Intrauterine Growth Retardation ◽  
Low Birthweight ◽  
Ponderal Index ◽  
Intrauterine Growth ◽  
Different Types

Originally all low birthweight infants were considered to be premature. When prematurity was redefined in terms of gestational age (SGA) and not preterm. With the large scale collection of obstetric data the distributions of birthweight at different gestational ages were described and from these, infants who were SGA could be defined. SGA became synonymous with terms such as growth retardation, but it soon became appearent that the two were not necessarily interchangeable. Scott and Usher found that it was the degree of soft tissue wasting rather than birthweight that related to poor perinatal outcome. Miller and Hassanein stated that: “birthweight by itself is not a valid measure of fetal growth impairment”. They used Rorher’s Ponderal Index (weight (g) × 100/length (cm)) to diagnose the malnourished or excessively wasted infants with reduced soft tissue mass. Most studies of intrauterine growth retardation (IUGR) still use low birthweight for gestational age centile as their only definition of IUGR or only study infants who have a low birthweight. Altman and Hytten expressed disquiet about this definition and stated: “There is now an urgent need to establish true measures of fetal growth from which deviations indicating genuine growth retardation can be derived” and that “it is particularly important that some reliable measures of outcome should be established”. In large series of term deliveries published recently, two groups of IUGR infants with different growth patterens have been identified. These studies confirm that birthweight alone is inadequate to define the different types of IUGR. They established that low Ponderal Index (PI) is a measure of IUGR associated with an increased incidence of perinatal problems and that it is time to re-evaluate IUGR in terms of the different types of aberrant fetal growth.

HUMAN FETAL GROWTH RETARDATION: I. CLINICAL FEATURES OF SAMPLE WITH INTRAUTERINE GROWTH RETARDATION

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 547-558
Author(s):  
J. Urrusti ◽  
P. Yoshida ◽  
L. Velasco ◽  
S. Frenk ◽  
A. Rosado ◽  
...  
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Fetal Growth Retardation ◽  
Neonatal Deaths ◽  
Intrauterine Growth ◽  
Normal Term

Intrauterine growth was assessed in a series of 128 cases. Thirty-six infants were small for gestational age, and showed the usual signs of intrauterine growth retardation (IUM). The head circumference of these infants was small, with reference to normal term babies (FT) and comparable to premature infants, appropriately sized for a gestational age (ACA) five weeks less than that of the IUM's. There were 12 neonatal deaths, three among IUM infants within 24 hours and nine in the low birth weight AGA group within 72 hours. The mothers of these three groups of infants were similar with respect to age, weight, height, nutritional patterns, and prior pregnancy histories.

Determinants of Fetal Growth and Body Proportionality

PEDIATRICS ◽  
1990 ◽  
Vol 86 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Michael S. Kramer ◽  
Marielle Olivier ◽  
Frances H. McLean ◽  
Geoffrey E. Dougherty ◽  
Diana M. Willis ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Relative Weight ◽  
Low Birth Weight Infants ◽  
Fetal Sex ◽  
Growth Ratio ◽  
Intrauterine Growth

Previous studies of fetal growth and body proportionality have been based on error-prone gestational age estimates and on inappropriate comparisons of infants with dissimilar birth weights. Based on a cohort of 8719 infants with validated (by early ultrasonography) gestational ages and indexes of body proportionality standardized for birth weight, potential maternal and fetal determinants of fetal growth and proportionality were assessed. Maternal history of previous low birth weight infants, pregnancy-related hypertension (particularly if severe), diabetes, prepregnancy weight, net gestational weight gain, cigarette smoking, height, parity, and fetal sex were all significantly associated with fetal growth in the expected directions. Consistent with previous reports, maternal age, marital status, and onset or total amount of prenatal care had no significant independent effects. Fetal growth ratio (relative weight for gestational age), pregnancy-related hypertension, fetal sex, and maternal height were the only significant determinants of proportionality. Infants who were growth-retarded, those with taller mothers, those whose mothers had severe pregnancy-related hypertension, and males tended to be longer and thinner and had larger heads for their weight, although these variables explained only a small fraction of the variance in the proportionality measures. Among infants with intrauterine growth retardation, gestational age was not independently associated with proportionality (in particular, late term and postterm infants did not tend to be more disproportional), a finding that does not support the hypothesis that earlier onset of growth retardation leads to more proportional growth retardation. The results raise serious questions about previous studies of proportionality, particularly those suggesting a nutritional etiology for proportional intrauterine growth retardation. They also emphasize the importance of controlling for degree of growth retardation, maternal stature, and pregnancy-related hypertension in evaluating the prognostic consequences of proportionality for mortality, morbidity, and functional performance.

Small for gestational age foetus

2014 ◽  
Vol 155 (33) ◽  
pp. 1301-1305
Author(s):  
Norbert Pásztor ◽  
Zoltán Kozinszky ◽  
Attila Pál
Keyword(s):  
Gestational Age ◽  
Growth Retardation ◽  
Small For Gestational Age ◽  
Intrauterine Growth Retardation ◽  
Pathological Condition ◽  
Labour Induction ◽  
Clinical Aspects ◽  
Optimal Timing ◽  
Screening Methods ◽  
Intrauterine Growth

A small for gestational age foetus is defined by the foetal weight below the 10th centile for the corresponding gestational age. However, the vast majority of these cases has no apparent underlying abnormality, while in other cases a serious causative pathological condition can be identified. The detection, follow-up and treatment of an intrauterine growth retarded, compromised foetus has great obstetric and neonatologic relevance. In this review, the causes, clinical aspects and screening methods of intrauterine growth retardation are summarized based on the most recent international guidelines. Furthermore, recommendations regarding the monitoring and the optimal timing of the labour induction of pregnancies complicated with intrauterine growth retardation are discussed. Orv. Hetil., 2014, 155(33), 1301–1305.

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