IUGR (Intrauterine Growth Restriction) and the Most Common Causes

Abstract

Intrauterine growth restriction (IUGR) is a complex and variable fetal condition, and it is a leading cause of perinatal morbidity and mortality, and may provoke cardiovascular, renal, immunological and neurological diseases later on life. Depending on the onset of condition, it was classified either early-onset (< 32week of gestation) or later-onset ( 32) IUGR is usually result from either maternal, fetal or placental disorder, or combination of those, leading into abnormal regulation of fetal growth. IUGR is commonly associated with growth that is small-for-gestation-age (SGA) and pathological changes in Doppler US. In high income countries, intrauterine growth restriction is most commonly associated with factors leading into placental insufficiency, that will lead into inadequate oxygen and nutrition transfer to fetus. Most common factors leading into IUGR are maternal lifestyle factors (e.g. smoking), hypertensive disorders, preeclampsia, malnutrition and chronic illnesses like chronic kidney disease and systemic lupus erythematous. Histologically these changes could be detected in placenta as maternal venous malperfusion, that are often consequence of remodeling of maternal spiral arteries. Congenital infections like cytomegalovirus, in the other hand could provoke chronic villitis, and thus leading into growth restriction of the fetus. Fetal factor like chromosomal abnormalities and exposure to teratogens can cause IUGR. Further examinations are still required to completely understand complex mechanisms of IUGR. With better understanding of placental angiogenic markers like PIFG it could also be possible to provide even better diagnostic options, especially as early screening parameter. As a health care provider, it is important to know the preventable risk factors of IUGR to provide proper interventions and treatment either before pregnancy or during pregnancy, to improve outcome of the fetus during pregnancy and after birth.

Intrauterine growth restriction (IUGR) is a complex and variable fetal condition, and it is a leading cause of perinatal morbidity and mortality, and may provoke cardiovascular, renal, immunological and neurological diseases later on life. Depending on the onset of condition, it was classified either early-onset (< 32week of gestation) or later-onset ( 32) IUGR is usually result from either maternal, fetal or placental disorder, or combination of those, leading into abnormal regulation of fetal growth. IUGR is commonly associated with growth that is small-for-gestation-age (SGA) and pathological changes in Doppler US. In high income countries, intrauterine growth restriction is most commonly associated with factors leading into placental insufficiency, that will lead into inadequate oxygen and nutrition transfer to fetus. Most common factors leading into IUGR are maternal lifestyle factors (e.g. smoking), hypertensive disorders, preeclampsia, malnutrition and chronic illnesses like chronic kidney disease and systemic lupus erythematous. Histologically these changes could be detected in placenta as maternal venous malperfusion, that are often consequence of remodeling of maternal spiral arteries. Congenital infections like cytomegalovirus, in the other hand could provoke chronic villitis, and thus leading into growth restriction of the fetus. Fetal factor like chromosomal abnormalities and exposure to teratogens can cause IUGR. Further examinations are still required to completely understand complex mechanisms of IUGR. With better understanding of placental angiogenic markers like PIFG it could also be possible to provide even better diagnostic options, especially as early screening parameter. As a health care provider, it is important to know the preventable risk factors of IUGR to provide proper interventions and treatment either before pregnancy or during pregnancy, to improve outcome of the fetus during pregnancy and after birth.