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Impact of intrauterine growth restriction on long-term health

Salam, Rehana A.; Das, Jai K.; Bhutta, Zulfiqar A.

Current Opinion in Clinical Nutrition & Metabolic Care: May 2014 - Volume 17 - Issue 3 - p 249–254
doi: 10.1097/MCO.0000000000000051
PAEDIATRICS: Edited by Berthold V. Koletzko and Raanan Shamir

Purpose of review Intrauterine growth restriction (IUGR) is responsible for the higher rates of fetal, perinatal, and neonatal morbidity and mortality. This review details the IUGR risk factors, its short and long-term sequel, the mechanism underlying the long-term consequences, and the strategies to tackle IUGR burden.

Recent findings Short-term consequences of IUGR involve metabolic, thermal, and hematological disturbances leading to morbidities. 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. There are no effective therapies to reverse IUGR, and antenatal management is aimed at determining the ideal time and mode of delivery. In order to prevent complications associated with IUGR, it is important to first detect the condition and institute appropriate surveillance to assess fetal well-being coupled with suitable intervention in case of fetal distress.

Summary Reliable prediction of IUGR may be achieved by combining clinical risk factors with Doppler abnormalities, fetal growth, and biomarkers. If this can be achieved, there is potential to reduce future perinatal morbidity, mortality and long-term consequences, but steps geared toward the prevention of IUGR are of unparalleled importance.

aDivision of Woman and Child Health, Aga Khan University, Karachi, Pakistan

bProgram for Global Pediatric Research, Hospital for Sick Children, Toronto, Ontario, Canada

Correspondence to Zulfiqar A. Bhutta, Founding Director, Center of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan. Tel: +92 21 34930051x4782; fax: +92 213 493 2095; e-mail: zulfiqar.bhutta@aku.edu

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