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Intrauterine growth retardation. An unmet challenge
Insights
Current fetal growth standards are inadequate. Revising them to account for factors like gestational age, ethnicity, and maternal characteristics is crucial for understanding intrauterine growth retardation (IGR).
Area of Science:
- Perinatology
- Fetal Medicine
- Neonatal Research
Background:
- Existing fetal growth standards are insufficient for accurately assessing fetal development.
- Lack of standardized criteria hinders clear understanding of intrauterine growth retardation (IGR).
Purpose of the Study:
- To highlight the inadequacy of current fetal growth standards.
- To advocate for revised standards that accurately represent normally grown fetuses and newborns.
- To emphasize the need for recognizing different types of IGR for better understanding.
Main Methods:
- Review and critique of existing fetal growth standards.
- Analysis of factors influencing fetal size, including gestational age, ethnicity, sex, maternal parity, height, and weight.
- Comparison of IGR incidence based on specific type diagnosis versus low birth weight for gestational age.
Main Results:
- Current fetal growth standards are deemed grossly inadequate.
- Specific intrinsic factors significantly affect fetal size and require proper allowances in growth standards.
- Diagnosing specific types of IGR revealed a significantly higher incidence compared to relying solely on low birth weight for gestational age.
Conclusions:
- Fetal growth standards require revision to accurately represent normal fetal and infant growth.
- Uniform data display and consideration of intrinsic factors are essential for improved fetal growth assessment.
- Recognition of diverse IGR types is critical for advancing the understanding of its pathogenesis, consequences, and incidence.
Abstract:
Most standards of fetal growth are grossly inadequate. Standards of fetal growth should be revised so that they represent normally grown fetuses and newborn infants; their data should be displayed in a uniform manner, and proper allowances should be made for intrinsic factors that affect fetal size significantly, namely gestational age, ethnic group, sex of infant, and maternal parity, height, and weight. The pathogenesis, consequences, and incidence of intrauterine growth retardation (IGR) will not be clearly understood until the different types of IGR are more widely recognized than at present. The incidence of IGR was observed to be significantly higher when the specific types of IGR were diagnosed rather than relying on low birth weight for gestational age, which does not distinguish between the different types of IGR.