Intrauterine Growth Restriction (IUGR): Etiology and Diagnosis

Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. IUGR is defined as fetus that fails to achieve his growth potential. Antenatal small for gestational age (SGA) is defined as fetus with weight < 10th percentile. IUGR and SGA are commonly used interchangeably. The identification of IUGR is important. IUGR identification begins with assessment of risk factor(s), and the diagnosis is made by ultrasound using biometry when this confirms an estimated fetal weight (EFW) of < 10th percentile. The common risk factors include maternal causes (hypertension, diabetes, cardiopulmonary disease, anemia, malnutrition, smoking, drug use), fetal causes (genetic disease including aneuploidy, congenital malformations, fetal infection, multiple pregnancies), and placental causes (placental insufficiency, placental infarction, placental mosaicism). Intrauterine growth determines the perinatal, postnatal, and adult life development. IUGR is associated with increased risk of development in adult life of metabolic diseases including but not limited to hypertension, diabetes, obesity, dyslipidemia, and the metabolic syndrome.