Intrauterine growth restriction (IUGR), also known as fetal growth restriction (FGR), is a condition in which babies appear smaller than expected. IUGR is usually diagnosed after an ultrasound shows that the baby weighs less than 10 kgºpercentile based on the number of weeks of pregnancy. IUGR can often be the result of a small father, but the condition can also be caused by problems with the placenta or umbilical cord, medical conditions such as preeclampsia, or other factors such as chromosomal abnormalities or smoking or drinking during pregnancy. If your baby has IUGR, your doctor will watch you both closely and you may go into labor early.
What is IUGR?
Babies are diagnosed with intrauterine growth restriction (IUGR) when they look smaller than expected. This would happen if aultrasoundindicates that the baby's weight is below the 10th percentile for her gestational age (weeks of gestation). Also called fetal growth restriction (FGR).
There are many reasons why a baby looks small. In many cases, a baby diagnosed with IUGR is small (perhaps just like one of its parents). And sometimes a baby that appears small in the womb at birth turns out to be a normal size. But in some cases, something is preventing the baby from growing properly, and the prenatal care provider will try to find out if there is a problem and what it is.
How will my caregiver know my baby's size?
Your caregiver will assess the size of your uterus during pregnancypelvic examination in the first trimester. She then checks the baby's growth by measuring her belly each timeprenatal visit. If the measurement (fundus height) is less than the due date, it means that it should be (it will be "small for dates"), will do an ultrasound to determine the size and weight of the baby.
You may measure slightly because your due date (based on your last period) is wrong. This can happen if you misremembered the first day of your last period or if you ovulated later than usual during your last cycle. Your doctor will review your first ultrasound (which can be used to determine the date of pregnancy) and the date of your period. If they are consistent and your baby's measurements are less than the 10th percentile for gestational age, your baby will be diagnosed with IUGR.
Fetal growth retardation: what causes it?
Apart from the small parent, these are the most common causes of IUGR:
- Abnormalities in the umbilical cord or placenta, the organ that supplies the baby with oxygen and nutrients in the womb. The placenta may not work properly if it is too small, irregularly shaped, or separates from the uterus (placental abruption). Placenta too low in the uterus (the previous cake) may slightly increase the risk of IUGR.
- Medical conditions you may have, such aschronic hypertensionfrompreeclampsia(especially if preeclampsia is severe and diagnosed in the second trimester or if you have chronic hypertension and preeclampsia), kidney or heart disease, certain types of anemia (such as sickle cell anemia), advanced diabetes, blood clotting disorders, autoimmune immune diseases, antiphospholipid syndrome or severe lung disease.
- Chromosomal abnormalities, such asDown syndromeor structural birth defects such as anencephaly (where part of the brain is missing) or abnormalities of the kidneys or abdominal wall.
- Loadingtwins or multiple multiples.
- Crow,drinks, or drug abuse.
- Certain infections that your baby may have contracted from you, such astoxoplasmosis,CMV,syphilis, fromround dog.
- Certain medications, such as some anticonvulsants.
- Severe malnutrition.
Furthermore, women who areunder weightbefore pregnancy and not gaining enough weight during pregnancy, and women living at very high altitudes are more likely to have slightly smaller babies.
If you have any of the above conditions, you will get an ultrasound to monitor your baby's growth, even if your abdominal measurements are normal at prenatal exams.
Even if you ever have onestillbirthor an IUGR baby, you can expect at least one ultrasound in the late second or early third trimester to check the baby's growth.
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How will this condition affect my IUGR baby?
Babies diagnosed with IUGR are more likely to have certain complications during pregnancy, during delivery and afterwards. The degree of risk depends on the cause of the growth problem, the severity of the growth restriction, the onset of pregnancy and the gestational age of the child at birth.
Research shows that babies whose weight is below the 10th percentile are more likely to have problems than babies who are at or above the 10th percentile. And the risk of short-term and long-term complications is higher for babies who are also born with growth restrictions.prematurely.
Babies with growth retardation have an increased risk of:
- have…section cchildbirth, because they have a harder time enduring labor
- Having an abnormally high red blood cell count at birth
- Low blood sugar, lower resistance to infections and difficulty maintaining body temperature after birth
- Meconium aspiration (when the baby inhales its own stool in the womb or during delivery).
- Being stillborn, due to lower levels of oxygen and nutrients in the womb
Will my baby have long-term effects from IUGR?
How a stunted baby fares in the long term depends in part on the cause of the growth problem. Most stunted babies who are normal eventually catch up to their peers, although some - especially premature babies - have developmental problems. For example, IUGR is associated with cerebral palsy.
Finally, some research suggests that stunted babies are more likely to become obese and develop heart disease, type II diabetes, and high blood pressure later in life.
What happens during pregnancy if my baby has IUGR?
First, you'll get a detailed ultrasound, in part to check the baby's anatomy and see if it has any structural defects that could be responsible for its stunted growth. Maybe you have it tooamniocentesisto check for chromosomal abnormalities, especially if structural defects are found by ultrasound or if growth restriction appears severe or is found early in pregnancy.
Depending on your situation, your caregiver may suggest blood tests or amniocentesis to see if an infection is the cause. And you will be closely watched for signs of preeclampsia.
Regardless of the cause of IUGR, you will have regular, usually weekly, ultrasounds to check your baby's size and growth rate since the last ultrasound and to assess the amount of amniotic fluid in your uterus. Your baby will also be monitoredstress-free testing,biophysical profiles, eDoppler ultrasound(to check blood flow to and from your baby).
Your carer may also ask you to do thisnumber of strokesto guide youbaby movements. This is a good way to monitor your baby's well-being between prenatal visits.
The time of delivery depends on how you and your baby are doing. For uncomplicated IUGR, delivery is the term. But if your baby is sick or very sick - with severepreeclampsia, for example – you may need to deliver early.
Is there anything I can do to help my baby diagnosed with IUGR?
First, remember that IUGR is not your fault and you probably didn't do anything to cause it. From now on:
Some health care providers prescribe medicationsstillness, but there is no evidence that it helps. In fact, the American College of Obstetricians and Gynecologists (ACOG) does not recommend resting before IUGR because it can cause harm—including blood clots, weakening of bones, and evendepression- to no avail.
- Make sure you have all yoursappointments for prenatal and fetal examinations.
- If you planned to give birth in a small community hospital, you may need to be transferred to a larger hospital with aneonatal intensive care unit (NICU)which can better solve all problems.
- If you smoke, drink alcohol or take drugs, we advise you to stop these activities if you have not already done so. (Don't be shy about asking your caregiver to refer you to a resource.)
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Babies with IUGR are at greater-than-normal risk for a variety of health problems before, during and after their birth. These problems include low oxygen levels while in the womb, a high level of distress during labor and delivery, and an increased risk of infectious disease after birth.What birth defects are associated with IUGR? ›
Single gene disorders, such as Cornelia de Lange syndrome, Russell Silver syndrome, Fanconi's anemia, Bloom syndrome and some skeletal dysplasias, have been associated with IUGR.Is IUGR linked to Down syndrome? ›
Risk Factors for Growth Restriction
Babies who have a chromosomal abnormality such as Down Syndrome, Turner Syndrome or an abnormality of one of their major organs more commonly have IUGR. Babies who have contracted an infection such as rubella, toxoplasmosis or cytomegalovirus whilst in the womb.
Long term consequences due to changes in the fetal nutritional environment is associated with increased risk of developing metabolic syndrome and cardiovascular disease, systolic hypertension, obesity, insulin resistance, and diabetes type II in adulthood.Do babies with IUGR have developmental delays? ›
IUGR leads to abnormal and delayed brain development. SGA is associated with decreased levels of intelligence and various cognitive problems, although the effects are mostly subtle.What are any four complications of IUGR? ›
- Increased risk for C-section delivery and premature birth.
- Breathing and eating problems at birth.
- Lack of oxygen at birth (hypoxia).
- Low blood sugar at birth (hypoglycemia).
- Trouble regulating body temperature.
- Meconium aspiration (your baby swallows their first poop).
IUGR may further represent a marker of prenatal factors that may be associated with autism risk such as metabolic alterations, ie, reduced insulin-like growth factor,62 fetal hypoxia,63 and perinatal inflammation.What is the survival rate of an IUGR baby? ›
IUGR babies often die at or soon after birth, with a death rate 5-20 times higher than normally grown infants. Much of this is due to death in the womb, suffocation during birth, and the presence of birth defects. Many infants who were growth-restricted never do catch up, perhaps one in every three.What is the average size of an IUGR baby? ›
For babies who are born near their due date (meaning, they aren't premature), the dangerous weight is anything less than 5 pounds, 8 ounces. Your doctor might suspect IUGR if he or she thinks your baby is growing slightly less than would be expected. IUGR is usually diagnosed during an ultrasound examination.When are babies with IUGR typically born? ›
While timing the delivery of the late preterm/early-term IUGR fetus requires consideration of multiple factors (e.g. degree of growth restriction, etiology, amniotic fluid volume, and biophysical and Doppler testing), available data suggests that delivery should occur by 37 to 38 weeks for singleton IUGR fetuses.
IUGR is diagnosed when ultrasound-estimated fetal weight is below the 10th percentile for gestational age. A diagnosis of IUGR implies a pathologic growth restriction responsible for low fetal weight [3–5].Can stress cause intrauterine growth restriction? ›
In most of these stressful conditions, fetal growth and development are impaired (Barker, 2001; Fowden et al. 2006; Hanson & Gluckman, 2014). The developmental changes can be severe and result in clinical intrauterine growth restriction (IUGR) with altered weight and proportions of the fetus as a whole.What is the most common maternal cause of intrauterine growth retardation? ›
Chronic hypertension is the most common cause of IUGR.Which type of IUGR is more common? ›
Asymmetrical IUGR is the most common manifestation of IUGR (∼ 70%), has a late onset, and is usually due to maternal systemic disease (e.g., hypertension) that results in placental insufficiency.Can IUGR cause mental retardation? ›
At 12 to 14 years of age the IUGR children had significantly lower mean IQ scores, 42% had either mental retardation or learning difficulties and 27% required special education compared to none of the controls.How long does it take for IUGR baby to catch-up? ›
The good news is that most IUGR/SGA babies experience immediate catch-up growth after birth, with the vast majority achieving full catch-up growth by age 2 years. In fact, if catch-up is to occur, it general occurs rapidly within the first 3 to 6 months after birth, and will typically be complete before 2 years of age.Do growth restricted babies catch-up? ›
Many studies have shown that growth-restricted children show catch-up growth in the first years after birth (1–6). Catch-up growth is recognized when a child shows accelerated growth, which is visualized as an upward crossing of its centiles in length or weight growth.What is the #1 reason for intrauterine growth retardation or low birth rate? ›
Often, IUGR happens because the fetus doesn't get enough nutrients and nourishment. This can happen if there is a problem with: the placenta, the tissue that brings nutrients and oxygen to the developing baby. the blood flow in the umbilical cord, which connects the baby to the placenta.What is low birth weight for autism? ›
Extremely low birth weight infants weighing less than 1 kg have an adjusted OR being diagnosed with ASD; OR,10.57 (95% CI 9.08–12.31) compared with NBW infants.What is the birth weight for autism? ›
Autism spectrum disorder (ASD) has been associated with low birth weight (<2,500 g) in prior research.
The common risk factors for IUGR include maternal, placental, environmental and fetal causes.How small is too small for a fetus? ›
This means they are smaller than 90% of (most) other babies of the same gestational age. Most babies weigh more than 5 pounds, 13 ounces by the 37th week of pregnancy. Babies born weighing less than 5 pounds, 8 ounces are considered low birth weight.What is the weight of the smallest baby to survive? ›
Tiny baby in Singapore, just 7.5 ounces, does home after 13 months in hospital. Washington Post. Chiu A. 'She's a miracle:' Born weighing about as much as 'a large apple,'Saybie is the world's smallest surviving baby.What are the ultrasound features of IUGR? ›
- reduced abdominal circumference (AC) and/or EFW. AC and/or EFW <3rd percentile. ...
- presence of oligohydramnios without ruptured membranes.
- increased head circumference (HC) to abdominal circumference (AC) ratio (in asymmetrical type)
- advanced placental grade.
The most common cause is a problem in the placenta (the tissue that carries food and blood to the baby). Birth defects and genetic disorders can cause IUGR. If the mother has an infection, high blood pressure, is smoking, or drinking too much alcohol or abusing drugs, her baby might have IUGR.What foods help fetal growth? ›
Protein — Promote growth
Protein is crucial for your baby's growth throughout pregnancy. Good sources: Lean meat, poultry, seafood and eggs are great sources of protein. Other options include beans and peas, nuts, seeds, and soy products.
Three or more servings of walnuts, legumes, and seafood each week. Three or more daily servings of vegetables. Two or more daily servings of fresh fruits and dairy products. White meat instead of red meat.How can I increase fetal growth? ›
Poultry: Eggs and chicken are great sources of protein. They help increase fetus weight along with the benefits of low cholesterol and Omega fatty acids. Soybean: A protein substitute for vegetarians, it also contains iron, healthy fats and fibre along with other minerals.What is the average delivery time for an IUGR baby? ›
The following are guidelines for delivering babies with IUGR: Baby has IUGR and no other complicating conditions: Baby should be delivered at 38-39 weeks.When does autism develop in the womb? ›
Researchers were thus able to demonstrate that the amygdala was normal in babies destined to become autistic up to 6 months, but between 6 and 12 months they began to see enlargement, before the clinical manifestations of the condition.