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Updated: Aug 23, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
[Intrauterine growth retardation: diagnostic and therapeutic approach]
A Di Cesare Merlone1, E Bozzola, R M Cerbo
1Dipartimento di Scienze Pediatriche, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
Insights
Growth hormone (GH) treatment can help small for gestational age (SGA) infants catch up in growth. However, monitoring insulin and glucose levels is crucial during treatment due to potential metabolic changes.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatology
Context:
- Intrauterine growth retardation (IUGR) describes poor fetal growth velocity, while small for gestational age (SGA) defines newborns below the 10th percentile for weight/length.
- Approximately 3-5% of newborns are SGA, with most achieving catch-up growth by age two.
- SGA is linked to later hypertension and dyslipidemia, highlighting the need for early intervention.
Purpose:
- To evaluate the effects of growth hormone (GH) treatment on SGA infants.
- To analyze the growth response factors and metabolic/biochemical changes during GH therapy.
Summary:
- GH treatment shows beneficial effects on growth in SGA infants, influenced by dose, bone age, and baseline hormone levels.
- GH therapy leads to reversible increases in insulin, proinsulin, and glucose, with decreased insulin sensitivity.
- Careful monitoring of insulin and glucose is essential during GH treatment for SGA children.
Impact:
- GH treatment can improve height standard deviation score (SDS) in SGA children, though bone maturation may accelerate.
- GH therapy positively impacts lipid profiles, decreasing total cholesterol, LDL, and the atherogenic index.
- Understanding GH's metabolic effects is vital for optimizing SGA infant management and long-term health outcomes.
Abstract:
Intrauterine growth retardation (IUGR) refers to the fetal growth pattern and assumes that at least 2 intrauterine growth assessments are performed, indicating a low growth velocity in the fetus. The term "small for gestational age" (SGA) does not refer to fetal growth but to the size of the infant at birth. Infants with SGA have a low weight and/or length for their gestational age at birth below the 10(th) percentile or -2 SD. Approximately 3-5% of all newborns are born SGA. The etiology of SGA/IUGR is not known. The majority (80-85%) of infants born SGA catch-up within the normal range by 2 years of age. SGA has also been associated with increased prevalence of hypertension and dyslipidaemia at a relatively young age. Most controlled trials have shown a beneficial effect of GH treatment. The growth response seems to be due to the cumulative dose received, parenteral adjusted height standard deviation score (SDS) and bone age pretreatment, baseline overnight peak of GH and IGF-I levels. During GH treatment, children born SGA show a significant increase in fasting levels of insulin and proinsulin and a decrease in insulin sensitivity. Fasting glucose levels significantly increase. All these effects are reversible upon interruption of treatment. However, fasting insulin concentrations as well as glucosylated hemoglobin must be carefully monitored during GH treatment. Total cholesterol, LDL cholesterol and the atherogenic index significantly decrease during GH treatment. An acceleration of bone maturation with GH treatment has been reported even though a gain in height SDS for bone age is demonstrated.
