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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
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Extrauterine Growth Restriction: Need for an Accurate Definition

Nitasha Bagga1, Nalinikanta Panigrahi1, Aaron Germain2

  • 1Department of Neonatology, Rainbow Children's Hospital, Hyderabad, Telangana, India; Global Newborn Society, Maryland, United States of America.

Newborn (Clarksville, Md.)
|November 17, 2023
PubMed

Insights

Neonatal growth varies significantly, influenced by prenatal and postnatal factors. Identifying extrauterine growth restriction (EUGR) is crucial for timely intervention and improved neurodevelopmental outcomes in infants born small for gestational age (SGA).

Area of Science:

  • Neonatalogy
  • Pediatric Growth and Development
  • Biometrics

Background:

  • Neonatal growth exhibits significant variability, measurable by weight, length, and head circumference.
  • Factors influencing birth measurements include maternal/paternal data, maternal metabolism, nutrition, and placental health.
  • Postnatal growth depends on feeding, caloric intake, metabolism, genetics, health conditions, medications, and environment.

Purpose of the Study:

  • To highlight the importance of recognizing and defining extrauterine growth restriction (EUGR) or postnatal growth restriction (PNGR).
  • To emphasize the link between EUGR/PNGR and potential abnormal neurodevelopmental outcomes.
  • To advocate for clear criteria for timely diagnosis and intervention of EUGR/PNGR.

Main Methods:

  • Serial biometric measurements (weight, length, head circumference) in neonates.
  • Consideration of subcutaneous and total body fat mass.
  • Analysis of factors influencing intrauterine and extrauterine growth.

Main Results:

  • Intrauterine growth restriction (IUGR) and being small for gestational age (SGA) can lead to persistent suboptimal growth (EUGR/PNGR).
  • A subset of growth-restricted infants faces a high risk of adverse neurodevelopmental outcomes.
  • Current criteria for recognizing EUGR/PNGR may be insufficient.

Conclusions:

  • Standardized criteria are needed to identify EUGR/PNGR accurately.
  • Early recognition and intervention are essential for improving growth trajectories and neurodevelopmental outcomes.
  • Further research should focus on defining precise diagnostic criteria for EUGR/PNGR.

Keywords:
Body fat massCohort of Indonesian PreTerm infants for long-term Outcomes studyCorrected gestational ageDelta-ZDemographic factorsExtra-uterine growth restrictionFailure to thriveFenton growth chartGenetic make-upInfant feedingInfant growthIntergrowth 21st chartsIntra-uterine growth restrictionLinear growth velocityMaternal and paternal anthropometricsMaternal metabolismMedicationsNeonatal morbiditiesNeonateNeurodevelopmental outcomesNewbornPlacental healthPostnatal growthPostnatal growth restrictionPostnatal malnutritionPostnatal morbiditiesPre-conceptional nutritional statusSmall for gestationTerm corrected ageTotal caloric intakeTotal metabolic activityWeight gain velocityZ-scoresgrowth charts

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