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Effects of Intrauterine Growth Restriction (IUGR) on Growth and Body Composition Compared to Constitutionally Small

Elisabeth Calek1, Julia Binder2, Pilar Palmrich2

  • 1Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria.

Nutrients
|October 14, 2023
PubMed

Insights

Intrauterine growth restriction (IUGR) significantly impacts infant fat-free mass (FFM) and growth velocity. Early nutritional intervention is crucial for IUGR infants to prevent impaired development and FFM loss.

Area of Science:

  • Neonatal Medicine
  • Pediatric Nutrition
  • Developmental Biology

Background:

  • Intrauterine growth restriction (IUGR) is linked to significant morbidities, including impaired neurodevelopment and growth restriction.
  • Small for gestational age (SGA) is often used as a proxy for IUGR but can also include constitutionally small infants, necessitating differentiation for appropriate nutritional management.

Purpose of the Study:

  • To compare body composition and growth velocity in infants with IUGR, SGA, and appropriate for gestational age (AGA) at term-equivalent age.
  • To determine the impact of being constitutionally small (SGA) versus growth-restricted (IUGR) on infant body composition.

Main Methods:

  • Retrospective analysis of 300 infants (2017-2022) born preterm (<37 weeks gestation).
  • Body composition (fat-free mass [FFM] and fat mass [FM]) and weight growth velocity were measured at term-equivalent age.
  • Comparison of infants with IUGR (n=40) and SGA (n=11) against AGA controls (n=249).

Main Results:

  • IUGR infants exhibited significantly lower FFM (p < 0.001) and weight growth velocity (p = 0.022) compared to AGA infants.
  • No significant differences in FFM or weight growth velocity were observed between SGA and AGA infants.
  • FFM Z-scores were significantly lower in IUGR infants (p = 0.017) compared to AGA, while SGA infants showed no impact on growth or body composition.

Conclusions:

  • Infants born with IUGR demonstrate distinct differences in FFM and growth compared to constitutionally small SGA infants.
  • Early and aggressive nutritional management is essential for IUGR infants to mitigate impaired growth and preserve FFM.
  • Differentiating IUGR from SGA is critical for tailoring nutritional strategies and improving long-term outcomes.

Keywords:
air displacement plethysmographyappropriate for gestational agebody compositionintrauterine growth restrictionnutritional managementpretermsmall for gestational age

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