Intrauterine Growth Retardation

Miller, Herbert C.

doi:10.1001/archpedi.1981.02130340050017

Cited by 53 publications

(11 citation statements)

References 25 publications

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“…The multiple regression model giving the expected birth weight logarithm (LnBW*), for an infant according to his (her) constitutional fetal and maternal characteristics, was as follows: LnBW* = a 1 GA + a 2 GA 2 + a 3 GA 3 + b S + c 1 Fetal length growth restriction after accounting for genetic growth potential*…”

Section: Methodsmentioning

confidence: 99%

“…Consequently, clinicians and researchers use the terms interchangeably. This is not a recent problem: in 1981, Miller [1] titled a paper 'IUGR an unmet challenge'; in 1987, Patterson and Pouliot [2] asked the question 'who is growth retarded? '; in 1989, Altman and Hytten [3] claimed 'IUGR lets be clear about!'.…”

Section: Introductionmentioning

confidence: 99%

“…In a recent review of the literature, we listed various solutions found for adjusting birth weight limits to maternal characteristics [15]. The classical method consisted of dividing the population into subgroups according to fetal or maternal characteristics, such as sex [1,11,[16][17][18][19][20][21][22][23][24][25][26], sex and parity [1,11,19], or race [1,17,19,26]. Based on a large sample, Thomson et al [11] gave a difference of more than 200 g between a girl born from a primiparous mother to a boy born from a multiparous one.…”

Section: Introductionmentioning

confidence: 99%

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Definition of Fetal Growth Restriction According to Constitutional Growth Potential

2001

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Identification of newborn babies with fetal growth restriction remains a problem both from the multi-factorial aspect of fetal growth and from statistical definition. Besides the usual terms: ‘Small for gestational age’ (SGA) and intrauterine growth retardation (IUGR), often used synonymously, the term ‘fetal growth retardation’ was recently introduced in reference to the genetic growth potential of infants. From a sample of 72,000 births, we have designed a statistical model in order to estimate the expected birth weight taking into account gestational age, sex, birth rank, maternal age, height and pregravid weight, we then calculated an individual limit of birth weight under that a newborn must be considered as having a ‘fetal growth restriction’ quoted FwGR. This new approach allowed us to identify 2 groups of newborns with FGR, one classically identified as SGA (noted FwGR_I) (3.9%), and the other newly identified as FGR (noted FwGR_II) (1.4%). In contrast, this approach allowed us to identify a group of ‘constitutionally small’ infants according to their constitutional growth potential (1.1%). In other words, among infants usually defined as SGA (5%), 22% appeared in fact to be ‘constitutionally small’ and therefore misclassified. As an initial validation, we observed that the proportion of maternal hypertension during pregnancy was low in the ‘constitutionally small’ infants (close to that of the normal group), and three times higher in the newly identified group FwGR_II than in the normal group. Following these results, it seems to be meaningful to follow-up this new group of FwGR_II infants, in terms of catch-up growth and neurodevelopmental outcome.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Definition of Fetal Growth Restriction According to Constitutional Growth Potential

2001

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“…Low-birthweight infants may be divided into 2 broad subgroups: preterm (< 37 wk gestation) and small for gestational age (SGA). The operational definition of SGA (ie, an infant born at term with a weight less than the standard reference weight) is affected by a lack of consistency in use of not only cutoff points-some authors using 2 SDs below the mean for gestational age and others the 5th or 10th percentile-but also in different intrauterine growth references (7,8). Limited data are available on length of gestation in developing countries, but most low-birth-weight infants appear to be SGA (9).…”

Section: Low Birth Weightmentioning

confidence: 99%

Potential interventions for the prevention of childhood pneumonia in developing countries: improving nutrition

Victora

Kirkwood²,

Ashworth³

et al. 1999

The American Journal of Clinical Nutrition

137

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Acute respiratory infections are the leading cause of childhood death in developing countries. Current efforts at mortality control focus on case management and immunization, but other preventive strategies may have a broader and more sustainable effect. This review, commissioned by the World Health Organization, examines the relations between pneumonia and nutritional factors and estimates the potential effect of nutritional interventions. Low birth weight, malnutrition (as assessed through anthropometry), and lack of breast-feeding appear to be important risk factors for childhood pneumonia, and nutritional interventions may have a sizeable effect in reducing deaths from pneumonia. For all regions except Latin America, interventions to prevent malnutrition and low birth weight look more promising than does breast-feeding promotion. In Latin America, breast-feeding promotion would have an effect similar to that of improving birth weights, whereas interventions to prevent malnutrition are likely to have less of an effect. These findings emphasize the need for tailoring interventions to specific national and even local conditions. Am J Clin Nutr 1999;70:309-20.

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“…In a Turkish study, Korkmazet al [6] documented an incidence of FM of 54.8% in preterm newborns and demonstrated its association with an increased risk of neonatal morbidity and mortality [5,8].The common feature of most causes of FM is decrease in the delivery and utilization of nutrients or oxygen or both to the developing fetus. Numerous animal experiments have shown that poor nutrition and other influences that impair growth during critical periods of early life may permanently affect the structure and physiology of a range of organs and tissues [9,10]. Since different tissues mature during different periods of fetal life and infancy, the long term consequences of altered nutrition depend on its timing and duration.…”

Section: Introductionmentioning

confidence: 99%

Determination of Fetal Malnutrition in Preterm Newborns

Ezenwa¹

2013

JFNS

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Abstract:Background: Fetal malnutrition has been associated with an increased risk of neonatal morbidities and mortalities and its proper documentation in a newborn is essential for optimal management of the child.Objective: To determine the nutritional status of preterm newborns at birth using CANSCORE and anthropometry and to compare the relative efficiency of CANSCORE and the anthropometric indices in detecting FM.Methods:The study was carried out on consecutive, singleton, live born babies of ≥28 completed weeks through 36 weeks gestation born at Lagos University Teaching Hospital, Lagos, Nigeria without any major congenital abnormalities or severe perinatal illness. Each infant was examined by the investigator within 48 hours of birth. Birth weights and lengths were recorded for each infant at birth. Using the Oloweintrauterine growth chart, birth weights for gestational age below the 3rd percentile and above the 97th percentile on the chart were taken as small for gestational age and large for gestational age respectively. PI was computed from the formula: PI = weight (g) / length 3 (cm) X100 . A PI <2.2 was considered as malnutrition.The MAC/HC ratio was calculated for each infant and value plotted on and compared with a standard curve. Clinical assessment of nutritional status score (CANSCORE) consisted of inspection and estimation of loss of subcutaneous tissues and muscles in the designated areas. A maximum score of 4 was awarded to each parameter with no evidence of malnutrition, and the lowest score of 1 was awarded to parameter with the worst evidence of malnutrition. Fetal malnutrition was defined as CANSCORE less than 25. Statistical analysis was done using the Epi info statistics software version 3.5.1.Results:One hundred and forty preterm newborns were assessed.One hundred and eight (77%) of them were of LBW. CANSCORE identified 34.3% of the babies as FM while PI, MAC/HC and birth weight identified 30.7%, 12.1 and 3.6% of the babies, respectively, as FM. The mean CANSCORE and anthropometry between males and females were not significantly different (p >0.05). Both CANSCORE and PI detected significantly large numbers of FM in the study sample compared with birth weight. All the anthropometric parameters showed low sensitivity in detection of FM (which is the visible wasting or loss of subcutaneous tissues and muscles) but they all had high specificity.Conclusion:FM is still prevalent in our environment even in preterm babies. CANSCORE identified moremalnourished subjects than anthropometry.

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Intrauterine Growth Retardation

Cited by 53 publications

References 25 publications

Definition of Fetal Growth Restriction According to Constitutional Growth Potential

Definition of Fetal Growth Restriction According to Constitutional Growth Potential

Potential interventions for the prevention of childhood pneumonia in developing countries: improving nutrition

Determination of Fetal Malnutrition in Preterm Newborns

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