Introduction
Intrauterine Growth Retardation (IUGR) is often related to very low birth weight (VLBW defined as < 1500 grams).
It is thought that in addition to genetic effects that programming by the uterine nutritional, oxygenation and endocrine fators may have a role in low birth weight and future
health problems.
Also look at the related page Fetal Origins Hypothesis.
Page Links: Introduction | Some Recent Findings | Australian NHMRC Recommendations |
WWW Links | References | Search Pubmed Now | Glossary
Some Recent Findings
Sheridan C.
Intrauterine growth restriction--diagnosis and management. Aust Fam Physician. 2005 Sep;34(9):717-23.
Ke X, Lei Q, James SJ, Kelleher SL, Melnyk S, Jernigan S, Yu X, Wang L, Callaway CW, Gill G, Chan GM, Albertine KH, McKnight RA, Lane RH.
Uteroplacental insufficiency affects epigenetic determinants of chromatin structure in brains of neonatal and juvenile IUGR rats.
Physiol Genomics. 2006 Mar 13;25(1):16-28.
"Intrauterine growth retardation (IUGR) increases the risk of neuroendocrine reprogramming. In the rat, IUGR leads to persistent changes in cerebral mRNA levels.
.... We conclude that IUGR results in postnatal changes in cerebral chromatin structure and that these changes are sex specific."
AHRQ Evidence-Based Clinical Information
The information below is modified from the AHRQ (USA) publication "Criteria for Determining Disability in Infants and Children: Low Birth Weight". (More? AHRQ publication link)
Study: Retrospective and prospective studies in infants or children who weighed 2,000 grams or less, whose gestational age was 35 week or less, or whose
birth weight or gestational age were below these thresholds. Preferences were given to recent studies and studies with a minimum of 6 months of follow-up.
Main Results: looked for evidence of association of very low birth weight (VLBW defined as < 1500 grams) with six outcome conditions.
The evidence of the literature overwhelmingly supports that the risk of cerebral palsy (CP) and major neurologic disability is increased among VLBW infants compared to full-term infants.
The literature is consistent in demonstrating that risk of CP, major neurosensory and/or neurologic disability is inversely proportional to the degree of immaturity whether measured by
gestational age or by birth weight.
- VLBW have higher rates of cognitive abnormality in early childhood and a several-fold increased prevalence of IQ < 70 as adults compared with children or adults who were born normal birth weight at term.
(evidence that even children who were apparently “well” VLBW infants during their neonatal course are also at significantly greater risk for both moderate and severe delay compared to larger birth weight groups)
- VLBW high risk for developing cognitive, neuromotor, and neurosensory disabilities including blindness and hearing loss.
(disabilities in turn may lead to other disabilities in speech and language, behavior problems and learning disabilities affecting school performance)
- VLBW strong evidence of increased incidence of speech and language delays in and extremely premature infants, and identified clinical
factors associated with the increased incidence. (short-term memory and language outcomes, preschool children who were born preterm performed
at a lower level, these deficits were independent of the general IQ)
- VLBW infants, with or without retinopathy of prematurity (ROP), are at increased risk of visual impairments and disability compared to children born full term.
(risk of visual disability in VLBW infants varies inversely with gestational age)
- VLBW infants with bronchopulmonary dysplasia (BPD) are at increased risk for long-term pulmonary disability.
(greater the severity of BPD, the greater is the association with long-term pulmonary impairment and need for re-hospitalization)
- VLBW infants, with or without other conditions, are at high risk for poor growth during the first years of life.
(due to acute neonatal illnesses, developmental delays, and chronic illnesses)
Agency for Healthcare Research and Quality USA (AHRQ)
Evidence-Based Clinical Information Criteria for Determining Disability in Infants and Children: Low Birth Weight
The Australian NHMRC Recommendations
Recommendations for neonates be assessed for follow-up care under the following conditions (1988). (Please note that current guidelines may differ from those listed below)
- Birthweight less than 1500g or gestational age less than 32 weeks
- Small-for-gestational-age neonates
- Perinatal asphyxia
- Apgar score less than 3 at 5 minutes
- clinical evidence of neurological dysfunction
- delay in onset of spontaneous respiration for more than 5 minutes and
requiring mechanical ventilation
- Clinical evidence of central nervous system abnormalities ie., seizures,
hypotonia
- Hyperbilirubinaemia of greater than 350umol/l in full term neonates
- Genetic, dysmorphic or metabolic disorders or a family history of serious
genetic disorder
- Perinatal or serious neonatal infection including children of mothers
who are HIV positive
- Psychosocial problems eg., infants of drug-addicted or alcoholic mothers.
References
Reviews
- Fowden AL, Giussani DA, Forhead AJ.
Intrauterine programming of physiological systems: causes and consequences.
Physiology (Bethesda). 2006 Feb;21:29-37.
- Fang S.
Management of preterm infants with intrauterine growth restriction.
Early Hum Dev. 2005 Nov;81(11):889-900.
- Sheridan C.
Intrauterine growth restriction--diagnosis and management.
Aust Fam Physician. 2005 Sep;34(9):717-23.
- Maritz GS, Morley CJ, Harding R.
Early developmental origins of impaired lung structure and function.
Early Hum Dev. 2005 Sep;81(9):763-71.
- Ergaz Z, Avgil M, Ornoy A.
Intrauterine growth restriction-etiology and consequences: what do we know about the human situation and experimental animal models?
Reprod Toxicol. 2005 Sep-Oct;20(3):301-22.
Articles
- Ke X, Lei Q, James SJ, Kelleher SL, Melnyk S, Jernigan S, Yu X, Wang L, Callaway CW, Gill G, Chan GM, Albertine KH, McKnight RA, Lane RH.
Uteroplacental insufficiency affects epigenetic determinants of chromatin structure in brains of neonatal and juvenile IUGR rats.
Physiol Genomics. 2006 Mar 13;25(1):16-28.
Search Pubmed Now
Click on the listed keywords below (used to search the external database) the most current references
on Medline will be displayed.
Intrauterine Growth Retardation (title) + review |
IUGR (title) + review
Glossary of Terms
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Finally
For those wanting to see dynamic processes of development (and have a reasonably
quick connection) then the Movies pages
are good for watching changes occur.
Other Embryos
The study of human development has relied extensively on studying the process
in other model animals. For those wanting to see the process of development
in other species then the other embryos
pages are a good start.
Comments

This page provides information about Intrauterine Growth Retardation (IUGR) and its effects on development.
See also the Prenatal Diagnosis page NSW Pamphlet Checking your baby's health before birth.
Please email Dr Mark Hill if you wish to make a comment about this current project.