[Intrauterine growth retardation and the developing brain]

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Neurodevelopmental Biology

Context:

• Fetal growth restriction (FGR) is a major cause of perinatal complications, second only to prematurity.
• It affects 5-12% of pregnancies and is often misdiagnosed as constitutionally small for gestational age.
• Accurate identification of pathological FGR is vital due to risks of intrauterine demise, chronic hypoxia, and impaired brain development.

Purpose:

• To highlight the importance of identifying true fetal growth restriction using customized growth curves.
• To emphasize the link between fetal growth patterns, perinatal management, and long-term neurodevelopmental outcomes.
• To underscore the need for further research on the neurodevelopmental effects of FGR and optimal intervention strategies.

Summary:

• Fetal growth restriction, distinct from being small for gestational age, requires identification using customized growth curves to detect pathological growth slowing or cessation.
• Prenatal markers and growth kinetics inform decisions regarding fetal extraction, gestational age at birth, and potential neurodevelopmental impacts.
• Short-term cognitive, motor, and behavioral issues associated with FGR may persist into adulthood, alongside an increased risk of metabolic syndrome.

Impact:

• Improved identification of fetuses at risk allows for optimized perinatal care and timely interventions.
• Understanding FGR's effects on brain development can refine fetal extraction decisions and C-section timing.
• Long-term monitoring with neurocognitive tools is essential to evaluate interventions and improve neurodevelopmental outcomes in affected children.