Intrauterine growth retardation (IUGR) is an obstetric pathology responsible for significant perinatal mortality. This alteration in fetal growth can be detected during pregnancy, mainly by estimating fetal weight measured on ultrasound.
Besides, third trimester ultrasound recommended in all pregnant women is used to monitor fetal growth and identify stunted fetuses.
Yet, according to a study by the National Institute of Health and Medical Research (Inserm), around 21% of babies with IUGR are not diagnosed during pregnancy. A figure that matches the estimates of the Prem’Up Foundation (a foundation for scientific cooperation on pregnancy and prematurity) which declared a few months ago that of the 80,000 babies born each year in France with in uterine growth retardation, 4 out of 5 are not diagnosed.
Inserm researchers therefore underline the need to reflect on the reasons for the poor performance of IUGR screening. Especially since their study of 14,000 women showed that nearly half of the children suspected of having IUGR finally had a normal birth weight. This suggests that half of the diagnoses are in fact false positives. However, the suspicion of IUGR during pregnancy is associated with an increase in risk of scheduled cesarean section before labor and induction of labor, regardless of whether or not a low birth weight exists.
IUGR: what are the causes
Despite the 3rd trimester ultrasound, growth retardation is still difficult to diagnose and “its prognosis is particularly complex to establish” explains Dr Jean-Marie Jouanic, head of gynecology-obstetrics department of the Trousseau hospital, in Paris. However, IUGR is a very high risk factor for perinatal mortality and it is also a major source of impairments and handicaps.
This growth retardation is due to the fact that the fetus does not receive enough oxygen or is poorly nourished. A problem that can be caused by certain chronic kidney diseases or hypertension in the mother-to-be or by her age (if she is under 18 or over 40). But certain risk behaviors can also be incriminated: smoking, the use of drugs or certain medications (anti-epileptics, immunosuppressants, corticosteroids) are factors that predispose to in-uterine growth retardation.
“However, this growth retardation is not trivial,” emphasizes the Prem’Up foundation. “It will cause a large number of deficiencies or handicaps from the neonatal period. These handicaps affect neurological and intellectual acquisitions and will also disrupt lung growth and hormone production. This will have consequences, including at age adult, with a significant risk of cardiovascular pathologies, hypertension, diabetes, and obesity “.
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