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Prematurity and intrauterine growth retardation--double jeopardy?

Rivka H Regev1, Brian Reichman

  • 1Neonatal Unit and Neonatal Follow-Up Clinic, Neonatal Department, Meir Hospital, Sapir Medical Center, Kfar Saba 44281, Israel. regevdr@netvision.net.il

Clinics in Perinatology
|August 25, 2004
PubMed

Insights

Infants born small for gestational age (SGA) with intrauterine growth restriction (IUGR) face higher risks of death and serious health issues. IUGR may also program later-life diseases like cardiovascular conditions and diabetes.

Area of Science:

  • Neonatalogy
  • Perinatology
  • Developmental Pediatrics

Background:

  • Intrauterine growth restriction (IUGR) significantly increases mortality and major neonatal morbidities in premature infants.
  • These complications, including respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC), are exacerbated by suboptimal fetal growth.
  • Emerging evidence links IUGR to the later development of adult-onset cardiovascular diseases, hypertension, and diabetes mellitus.

Purpose of the Study:

  • To discuss the pathophysiologic processes underlying IUGR and its consequences.
  • To highlight the role of IUGR as a risk factor for long-term health problems.
  • To emphasize the need for experimental research into IUGR's etiology and pathophysiology.

Main Methods:

  • Review of pathophysiologic processes initiated in utero and continuing postnatally.
  • Analysis of recently reported data on IUGR and long-term health outcomes.
  • Discussion of experimental research directions.

Main Results:

  • Premature infants with IUGR exhibit a substantially increased risk of mortality and severe neonatal morbidities.
  • Suboptimal fetal growth intensifies the severity of prematurity-related complications.
  • IUGR is identified as a programming risk factor for adult cardiovascular diseases, hypertension, and diabetes.

Conclusions:

  • Understanding the pathophysiology of IUGR is crucial for addressing neonatal complications.
  • Interventions targeting IUGR may reduce both short-term and long-term mortality and morbidity in small for gestational age (SGA) infants.
  • Further experimental research is essential to develop effective strategies for mitigating the risks associated with IUGR.

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