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Published on: June 29, 2013
Intrauterine growth restriction-etiology and consequences: what do we know about the human situation and experimental
Zivanit Ergaz1, Meytal Avgil, Asher Ornoy
1Laboratory of Teratology, Department of Anatomy and Cell Biology, Hebrew University Hadassah Medical School, Jerusalem, Israel.
Insights
Intrauterine growth restriction (IUGR) affects 7-9% of newborns, stemming from maternal, placental, fetal, or environmental factors. Preventing IUGR remains a distant goal despite various research models.
Area of Science:
- Obstetrics and Gynecology
- Developmental Biology
- Genetics
Background:
- Embryonic and fetal development are influenced by complex interactions between genetic and environmental factors.
- Intrauterine growth restriction (IUGR), defined as birth weight below the 10th percentile, affects 7-9% of live-born infants.
- IUGR prevalence and severity vary significantly across different ethnicities and socio-economic statuses.
Purpose of the Study:
- To review the multifactorial causes of intrauterine growth restriction (IUGR).
- To discuss the limitations of current animal models in reflecting human IUGR causality.
- To highlight the challenges in achieving the ultimate goal of IUGR prevention.
Main Methods:
- Literature review of known and suspected causes of IUGR.
- Analysis of maternal, placental, fetal, and environmental contributing factors.
- Evaluation of existing animal models for IUGR research.
Main Results:
- Identified key IUGR causes including maternal malnutrition, chronic diseases, placental pathology (e.g., pre-eclampsia, thrombophilia), infections, fetal syndromes, and lifestyle factors (smoking, alcohol).
- Noted that animal models, while informative, do not fully replicate the complex causality of human IUGR.
- Highlighted the significant gap between current understanding and the ability to prevent IUGR.
Conclusions:
- IUGR is a complex condition with diverse etiologies, necessitating a comprehensive understanding of contributing factors.
- Current animal models offer insights but have limitations in fully recapitulating human IUGR.
- Effective prevention strategies for IUGR are still under development, indicating a need for further research.
Abstract:
Embryonic and fetal growth depend on genetic and environmental factors, and the process is the result of the interaction between these factors. About 7-9% of live-born infants have a birth weight below normal (below the 10th percentile). The rate and extent of intrauterine growth restriction (IUGR) varies by ethnicity and socio-economic status. Some of the suspected causes of IUGR are as follows. (1) Maternal factors such as inadequate or severe malnutrition, chronic maternal diseases, birth order, multiple births, and parental genetic factors. (2) Placental pathology, mainly placental vascular damage that may lead to placental insufficiency. This is often found in maternal diseases such as pre-eclampsia, and Thrombophilia. (3) Intrauterine infections and specific fetal syndromes, including chromosomal aberrations. (4) Non-classified causes such as adolescent's pregnancy, maternal smoking and alcohol drinking, living at high altitudes. Several existing animal models for IUGR, including uterine artery ligation or gene knock out models, although insightful of potential mechanism(s) underlying intrauterine growth restriction, are limited in that they do not reflect human causality. As the ultimate goal is prevention, we seem still to be distant from achieving this goal.
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