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Published on: June 29, 2013
Intrauterine Intervention for the Treatment of Fetal Growth Restriction
A-M Spiroski, M H Oliver, J E Harding
1Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand. f.bloomfield@auckland.ac.nz.
Insights
Fetal growth restriction (FGR) increases risks for newborns. Intrauterine interventions show promise for improving fetal growth, survival, and long-term health outcomes.
Area of Science:
- Perinatal Medicine
- Developmental Biology
- Neonatology
Background:
- Fetal growth restriction (FGR) is linked to higher rates of fetal/neonatal death and morbidity.
- FGR infants face postnatal complications, increasing risks for adult chronic diseases.
- Current interventions for FGR lack effectiveness in improving perinatal survival or intrauterine growth.
Purpose of the Study:
- To explore the potential of intrauterine interventions for FGR.
- To assess if intrauterine interventions can improve fetal growth and long-term outcomes.
- To mitigate risks associated with postnatal growth acceleration in FGR infants.
Main Methods:
- This study is a review of current literature and clinical approaches to FGR.
- Analysis of the potential benefits and risks of intrauterine versus postnatal interventions.
- Evaluation of the impact of nutritional and growth support in utero.
Main Results:
- No effective clinical interventions currently exist to improve perinatal survival or intrauterine growth in FGR.
- Postnatal growth acceleration in FGR may increase risks of metabolic dysregulation and chronic disease.
- Intrauterine interventions could potentially reduce mortality and improve long-term outcomes.
Conclusions:
- Intrauterine interventions offer a potential strategy to improve outcomes for fetuses with FGR.
- Improving fetal nutrition and growth in utero may decrease preterm delivery and postnatal risks.
- Further research into intrauterine interventions is warranted to enhance FGR infant health.
Abstract:
Fetal growth restriction (FGR) is associated with an increased incidence of fetal and neonatal death, and of neonatal morbidity. Babies born following FGR also are at risk of a range of postnatal complications, which may contribute to an increased incidence of disease later in life. There currently are no effective clinical interventions which improve perinatal survival, intrauterine growth and later outcomes of the FGR baby. Postnatal interventions aimed at promoting or accelerating growth in FGR babies to improve outcome, particularly neurodevelopmental outcomes, may further increase the risk of metabolic dysregulation and, therefore, the risk of developing chronic disease in adulthood. An intrauterine intervention to improve nutrition and growth in the FGR fetus may have the potential to decrease mortality and improve long-term outcomes by delaying preterm delivery and mitigating the need for and risks of accelerated postnatal growth.
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