![]() Maternal infection and parasite infestations (TORCH, malaria, tuberculosis, urinary tract infections and bacterial vaginosis).Pathological conditions in pregnancy like preeclampsia and diabetes associated with vasculopathy.Maternal medical disorders (hypertensive disorders (gestational and non-gestational), diabetes associated with vasculopathy, chronic renal disease, systemic lupus erythematosus, antiphospholipid syndrome, sickle cell disease.Hematologic and immunologic disorders (Acquired thrombophilias, such as anti-cardiolipin antibodies and lupus anticoagulant).Maternal Bronchial asthma, cyanotic congenital heart diseases.Assisted reproductive technologies (ART).Inter pregnancy interval (less than 6 months or 120 months or more).Maternal pre-pregnancy height and weight (BMI less than 20, weight less than 45 kg and more than 75 kg).Maternal medication (warfarin, steroids, anticonvulsants, antineoplastic, anti-metabolite, and folic acid antagonists).Maternal substance abuse (smoking both active and passive, alcohol, illicit drugs like marijuana or cocaine).Low socioeconomic status and developing country.Maternal age (less than 16 years and more than 35 years).1 In this review, IUGR and SGA have been used interchangeably, and we have covered various antenatal and postnatal features of IUGR in brief details on these aspects can be seen in other published review articles of the author. The same definition of IUGR and SGA holds true for LBW infants too. Low birth weight (LBW) is a separate entity and should not be confused with IUGR/SGA, as the definition of LBW is based on the birth weight (less than 2,500 g) irrespective of gestational age, sex, race, and clinical features. Therefore, it is important to keep in mind that neonates with a birth weight less than the 10th percentile will be SGA, but not an IUGR if there are no features of malnutrition, and a neonate with a birth weight greater than the 10th percentile will be an IUGR in spite of being an AGA, if the infants have features of malnutrition at birth. Henceforth, appropriate for gestational age (AGA) infants can be labeled as IUGR if they have features of in-utero growth retardation and malnutrition at the time of birth. ![]() ![]() An IUGR is a clinical definition and applies to neonates born with clinical features of malnutrition and in-utero growth retardation, irrespective of their birth weight percentile. SGA definition is based on the cross-sectional evaluation (either prenatal or postnatal), and this term has been used for those neonates whose birth weight is less than the 10th percentile for that particular gestational age or two standard deviations below the population norms on the growth charts, and the definition considers only the birth weight without any consideration of the in-utero growth and physical characteristics at birth. The terms “IUGR” and “small for gestational age (SGA)” have been used synonymously in medical literature, but there exist small differences between the two. The “normal” neonate is the one whose birth weight is between the 10th and 90th percentile as per the gestational age, gender and race with no feature of malnutrition and growth retardation. It has also been described as a deviation from or a reduction in an expected fetal growth pattern and is usually the result of innate reduced growth potential or because of multiple adverse effects on the fetus. Intrauterine growth restriction (IUGR) has been defined as the rate of fetal growth that is below normal in light of the growth potential of a specific infant as per the race and gender of the fetus. In this review, we have covered various antenatal and postnatal aspects of IUGR. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality.
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