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Babies who have Intrauterine Growth Restriction are smaller than normal but what is up with this condition exactly? What causes IUGR, and what does it mean for a baby?

What is IUGR?

Intrauterine Growth Restriction, which is abbreviated as IUGR, is poor fetal growth during pregnancy. The exact definition is not clear, and the diagnosis of IUGR is subject to individual doctors' opinions. Generally speaking, IUGR is diagnosed when a fetus has been shown, on ultrasound, to be below the 10th percentile for its current gestational age. When measuring this, the fact that ultrasound can be inaccurate in determining fetal size has to be taken into account. There are two types of Intrauterine Growth Restriction. In one type, the whole fetus is simply smaller than expected, with the body proportions being normal.

This is known as symmetrical Intrauterine Growth Restriction or primary IUGR. When this happens, the option that the gestational age has been miscalculated should be taken into account before a diagnosis is made. In the second type of Intrauterine Growth Restriction, the baby's proportions are different than normal the head is bigger than the torso and the rest of the body.This is called asymmetric IUGR or secondary IUGR. IUGR is generally diagnosed after an OBGYN finds that the baby is too small for gestational age, and possibly has different proportions, during an ultrasound. A physical examination will also show that the mother's uterus is smaller, and that her fundal height is not as large as expected.

IUGR causes

There are many different risk factors for Intrauterine Growth Restriction. These risk factors include infections during pregnancy, like rubella, toxoplasmosis, or syphillis. Alcohol and drug addition are possible causes of IUGR too, along with smoking. Then there are medical conditions like maternal high blood pressure or kidney disease. Anything that messes with the baby's oxygen and nutrition supply can lead to IUGR. Placental complications, twin gestation, preeclampsia and even living at high altitudes are all possible examples of health issues that are associated with Intrauterine Growth Restriction. Birth defects and chromosomal abnormalities also increase the risk of IUGR, as does too little amniotic fluid which is incidentally another indicator of birth defects and chromosomal issues as well. Finally, mothers who are underweight or malnourished are more likely to have babies with IUGR. Mothers who are genetically small tend to have smaller babies too. In this case, the small baby should not be diagnosed with a growth restriction because it is developing normally.

Is there any treatment?

There is no treatment for Intrauterine Growth Restriction as such. in cases of malnutrition, an improvement in maternal diet will certainly improve the health of the fetus as well. Alcohol, drug and cigarette abuse should be stopped immediately with the right treatment, and this would have a positive effect on the unborn baby too. Most cases of IUGR have no clear, immediately identifiable cause. There is not much doctors can do for these babies, except provide more frequent and careful prenatal monitoring. After 34 weeks gestation, an early delivery is often recommended particularly for IUGR babies with the asymmetric type of growth restriction. Vaginal delivery carries more risks than cesarean section for such babies, stillbirth is statistically more likely for IUGR babies, and medical professionals will be better able to help the baby grow once it's on the outside of the womb, even if it will need NICU care.

IUGR babies after birth

If your baby has been diagnosed with Intrauterine Growth Restriction, you will be wondering how the diagnosis can affect your baby after birth. It is hard to say much about that, beyond that the problems an IUGR baby may encounter after birth depend on the cause of the growth restriction. Babies without an identifiable cause of IUGR may face slower growth after birth, or may catch up. They may turn out to be simply small. Those who were exposed to alcohol, infections or poor nutrition during pregnancy are more likely to have permanent consequences. Babies with birth defects or chromosomal abnormalities will require specialized medical care. Parents of babies diagnosed with IUGR are best off discussing the risks with their medical team, based on the cause of the growth restriction in their case, if it's known.

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