[Growth charts and intrauterine growth retardation]

J-B Gouyon1, C Ferdynus, C Quantin

  • 1Centre d'études périnatales de l'Océan Indien, groupe hospitalier Sud Réunion, CHU, BP 350, avenue François-Mitterrand, 97448 Saint-Pierre cedex, France. jean-bernard.gouyon@chu-reunion.fr

Insights

Intrauterine growth restriction (IUGR) means a fetus isn't reaching its growth potential. While growth charts help estimate this, their individual predictive value for fetal and neonatal outcomes is limited.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatology
  • Pediatric Growth and Development

Context:

  • Intrauterine growth restriction (IUGR) signifies a fetus failing to achieve its genetic growth potential.
  • Growth charts, both fetal and neonatal, are used to approximate individual growth potential.
  • Fetal growth charts estimate fetal weight from biometric data, while neonatal charts use birth weight.

Purpose:

  • To differentiate between fetal and neonatal growth charts and their respective applications.
  • To highlight the differences and limitations of current growth charting methods for assessing intrauterine growth restriction.
  • To underscore the clinical and epidemiological significance of IUGR and its associated risks.

Summary:

  • Neonatal and fetal growth charts are not interchangeable and have distinct clinical and epidemiological meanings.
  • Fetal growth charts assess growth velocity, but individual fetal weight estimation can lack precision.
  • Neonatal charts, based on population data, differ significantly from fetal charts, especially for preterm infants often affected by maternal conditions.

Impact:

  • Intrauterine growth restriction (IUGR) is a significant risk factor for fetal mortality, neonatal mortality, and both short- and long-term morbidity.
  • Despite the risks, the predictive accuracy of current growth charts, customized or not, at an individual level is low.
  • Further investigations are necessary to improve the predictive value of growth assessments for individual fetal and neonatal outcomes.

Related Concept Videos

Population Growth00:57

Population Growth

Population size is dynamic, increasing with birth rates and immigration, and decreasing with death rates and emigration. In ideal conditions with unlimited resources, populations can increase exponentially, which plots as a J-shaped growth rate curve of population size against time. This type of curve is characteristic of newly-introduced invasive species, or populations that have suffered catastrophic declines and are rebounding.
Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
Regression Toward the Mean01:52

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...
Exponential Equations for Modeling Growth01:26

Exponential Equations for Modeling Growth

Exponential models are essential for describing rapid, multiplicative changes in natural systems, such as population growth. When a population doubles at regular intervals, the process can be modeled using a suitable base. For instance, a bacterial culture that doubles every three hours follows the model n(t)=n0⋅2t/3, where n(t) is the population at the time t.A more general model uses the natural base e, especially for continuous growth. This takes the form n(t)=n0⋅ert, where r is the relative...
Microbial Growth Measurement: Indirect Methods01:27

Microbial Growth Measurement: Indirect Methods

Estimating microbial growth is essential for understanding population dynamics and environmental adaptations. Indirect methods provide valuable insights by measuring parameters such as turbidity, metabolic activity, and biomass, enabling efficient and reproducible assessments.During exponential growth, microbial cells scatter light proportionally to their biomass, a principle used in turbidity measurements. About one million cells per milliliter produce detectable scattering, which a...
Bacterial Growth Curve01:28

Bacterial Growth Curve

The bacterial growth curve is a fundamental concept in microbiology that describes the dynamics of bacterial population growth in a closed system with controlled environmental conditions, such as temperature and nutrient availability. This curve is divided into four distinct phases: lag, log (exponential), stationary, and death phases, each reflecting a unique stage of bacterial adaptation and growth. During the lag phase, bacteria acclimate to their surroundings by synthesizing essential...