Intrauterine growth retardation is a condition that is often recognized in babies that are born at or below the tenth percentile for their gestational age. Although approximately 350,000 infants are born weighing below the tenth percentile in the United Stated each year, only about 100,000 are actually diagnosed with IUGR. Many times, low birth weight in infants can be attributed to a low maternal weight or other factors. In these instances, babies normally "catch up" as their age progresses.
IUGR should be evaluated and treated as early as possible, as this condition can raise the risk for more significant health problems. For most babies who suffer from IUGR, however, the prognosis is very good.
What causes intrauterine growth retardation ?
There are various factors that should be considered when evaluating the causes of, and diagnosing and infant suspected of suffering from IUGR. Such factors as the size and weight of the mother, the phenotype of the father, and even higher altitude residency can affect the birth weight of an infant. When these factors are taken into consideration, many children are referred to as "constitutionally small". This term describes children who are of a lower birth weight, but otherwise healthy.
When these factors do not apply, or seem less relevant, or the low birth weight is severe, the child is often said to suffer from Intrauterine growth retardation.
The most common cause of IUGR is poor maternal-fetal circulation resulting in failure to thrive. Other causes include congenital abnormalities and intrauterine infections during pregnancy.
Medical factors that influence IUGR include:
- Early preeclampsia- Preeclampsia causes significant damage to the placenta, resulting in poor blood flow to the infant.
- Hypertension- Perinatal mortality is three times more likely in infants with hypertensive mothers.
- Chronic renal disease
- Inflammatory bowel disease
- Severe lung disease
- Infections account for approximately ten percent of all cases of Intrauterine growth retardation.
- Hepatitis B
- Alcohol use
- Cocaine use
- Use of Warfarin or Phenytoin
- Prior pregnancies resulting in infants with IUGR
While prevention is not always possible, expectant mothers should remove as many risk factors as possible to help prevent their infants from suffering from IUGR. Stopping smoking, alcohol use, and drug use can be an important step in reducing the risk. In addition, expectant mothers should focus on consuming a nutritional diet. Any medications taken during pregnancy should be approved by the attending physician.
When IUGR is suspected, many times physicians will recommend an early or preterm delivery of the baby to prevent further development of IUGR. This can be done by inducing preterm labor, or by cesarean delivery.
While most children suffering from IUGR will eventually catch up on their own, much of the prognosis is dependent upon the cause of the growth retardation.
There are many reasons a child won't have catch up growth. About 10% of children born IUGR do not catch up (my son being one of them), however there are also medical conditions such at growth hormones deficiency's, Celiac disease and many more or genetic conditions such as metabolic disorders that will prevent the child from ever fully developing normally.
In some instances, Growth Hormones are recommended to assist the child in reaching average size, and developing properly.
Consult with your endocrinologist for proper testing to determine the cause of inadequate growth.