Related Experiment Video
Updated: Jun 21, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal management and long-term sequelae
1Perinatal Medicine, Royal Maternity Hospital, and Department of Child Health, Queen's University Belfast, Belfast, Northern Ireland. h.halliday@qub.ac.uk
Insights
Fetal growth restriction, defined by customized birth weight percentiles, has asymmetric or symmetric causes impacting infant health. Understanding the cause is key to managing risks like birth asphyxia, developmental issues, and long-term disease.
Area of Science:
- Perinatology
- Neonatology
- Pediatric Endocrinology
Background:
- Intrauterine or fetal growth restriction (IUGR) is best defined using customized birth weight percentiles tailored to individual infant growth potential.
- Growth restriction can be asymmetric, often due to placental insufficiency or maternal factors, or symmetric, linked to congenital issues or environmental influences.
- The etiology of growth restriction significantly influences potential adverse outcomes for the fetus, newborn, and long-term health in childhood and adulthood.
Purpose of the Study:
- To elucidate the classification, causes, and consequences of intrauterine or fetal growth restriction.
- To outline the management strategies for different types of growth restriction and their associated risks.
- To discuss the long-term implications of growth restriction, including catch-up growth and potential adult-onset diseases.
Main Methods:
- Classification of growth restriction into asymmetric and symmetric types based on duration and underlying causes.
- Identification of etiological factors for each type, including placental insufficiency, maternal conditions, congenital infections, and genetic abnormalities.
- Review of potential adverse effects on neonates and long-term health outcomes, including developmental issues and metabolic syndrome.
Main Results:
- Asymmetric growth restriction is linked to placental insufficiency and maternal factors, potentially causing fetal hypoxia, birth asphyxia, and neonatal complications.
- Symmetric growth restriction may indicate congenital infections or abnormalities requiring specific interventions, while constitutional short stature needs minimal management.
- Excessive catch-up growth post-birth increases the risk of adult insulin resistance, diabetes, obesity, and heart disease; IUGR also elevates cerebral palsy risk.
Conclusions:
- Accurate definition and classification of fetal growth restriction are crucial for predicting and managing associated risks.
- Management should be tailored to the underlying cause, focusing on preventing neonatal complications and addressing specific congenital issues.
- Long-term monitoring is essential, as excessive catch-up growth may predispose individuals to metabolic disorders and other chronic diseases in adulthood.
Abstract:
Intrauterine or fetal growth restriction is best defined by using customised birth weight percentiles based upon the growth potential for an individual infant. Growth restriction in utero may be classified as asymmetric or symmetric depending upon the duration of the process. Asymmetric growth restriction is caused by placental insufficiency, maternal hypertensive conditions, long-standing maternal diabetes, smoking, living at altitude or multiple gestation. Symmetric growth restriction may be due to congenital infections, chromosomal or other abnormalities, fetal alcohol syndrome, low socioeconomic status or be constitutional. The underlying cause of growth restriction often predicts the potential adverse effects on the foetus and newborn and later effects in childhood and adulthood. With placental insufficiency, there may be chronic or acute on chronic fetal hypoxia with birth asphyxia and hypothermia, neonatal hypoglycaemia, polycythaemia and coagulopathy. Management is directed at prevention or early treatment of these conditions. In contrast, symmetrically growth-restricted infants should be examined carefully to look for congenital infections and malformations that may need specific interventions. Infants with constitutional short stature generally do not need any specific management. Feeding of growth-restricted infants is important to overcome deficiencies incurred in utero. Most infants show catch-up growth although about 10% do not. Those with excessive catch-up growth may be at greatest risk of developing insulin resistance in adulthood leading to diabetes, obesity and heart disease. The so-called fetal origins of disease may actually have a postnatal onset related more to excessive weight gain in infancy. There is still controversy over the indications for growth hormone treatment in growth-restricted infants who remain of short stature in early childhood. Intrauterine growth restriction is also associated with a five- to seven-fold increased risk of cerebral palsy probably due to chronic placental insufficiency.
Related Concept Videos
01:22Myocarditis IV: Nursing Management
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:29Endocarditis IV: Nursing Management
01:18Endocarditis III: Medical Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management