The role you play in your babies’ development

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Fetal Growth Restriction

The failure of a foetus to reach its full growth potential is known as fetal growth restriction (FGR). This is associated with a significant increased risk of perinatal morbidity and mortality. Growth restricted foetuses are more likely to suffer intrauterine hypoxia/asphyxia and , as a consequence, be stillborn or show signs of and symptoms of hypoxin-ischaemic encephalopathy (HIE), including seizures and multi-organ damage. Other complications which growth restriction can cause are neonatal hypothermia, hypoglycaemia, and infections. Cerebral palsy is more common too among the affected babies. Several studies have suggested that low birth weight infants are more likely to develop hypertension, cardiovascular disease (ischaemic heart disease and stroke) and diabetes in adult life which implicates that the effect of FGR is long lasting on the affected babies.

It is worthy to say that not all small for gestational age (SGA) foetuses are growth restricted; some of these babies are naturally or constitutionally small and have reached the peak of their growth potential. In addition not all growth restricted foetuses are SGA in that while their birth weight is within the normal range for gestation they have failed to reach their growth potential. Recognising which is which is the function of your obstetrician.

Fetal growth is dependent on adequate transfer of nutrients and oxygen across the placenta. This itself is dependent on appropriate maternal nutrition and placental perfusion. Factors such as pre-eclampsia,fetal hormones and other disorders of placentation play important role. Insulin and thyroxine (T4) are required through late gestation to ensure appropriate growth in normal and adverse nutritional circumstances. Others factors are fetal influences and maternal influences;

Fetal influence

Genetic: Obvious and severe FGR is seen in foetuses with chromosomes defects. Less severe FGR is common with Down syndrome. The sex of the foetuses also plays a role in the birth weight; males are slightly greater than females.

Infections: Not too common but Rubella, cytomegalovirus and syphilis have influence on the foetuses.

Maternal Influences

Maternal height and weight: Mothers here tend to have bigger babies.

Previous pregnancy weight

Age: Older women tend to have increased risk of chromosomal abnormalities and maternal disease e.g. hypertension. Teenagers are also associated with FGR

Ethnic group: Women from South Asian and Afro Caribbean tend to have lighter babies.

Behavioural influences like Smoking, alcohol, drugs negatively affect the growth of the baby. Toxins have bad influences as it can penetrate through the placenta. Alcohol also crosses the placenta and a dose related effect has been noted with up to 500g reduction in birthweight along with other anomalies occurring in women who drink heavily. Same effect also noticed with the use of heroine.





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