Foetal nutrition, foetal growth restriction and health later in life.
Retarded intrauterine growth has been linked to increased risk of perinatal mortality and morbidity, sudden infant death and poorer health later in life. The independent variables used in these studies are mainly neonatal size parameters, such as weight, ponderal index and ratios of head and abdominal measures. These are, in terms of foetal development and growth, crude parameters. This paper discusses the concepts of growth retardation used in most clinical and epidemiological studies. It is again emphasized that small for gestational age (SGA) and intrauterine growth retardation (IUGR) are different concepts. SGA is a size parameter that may or may not reflect restricted foetal growth and is therefore of limited value. Even IUGR, defined as retarded foetal growth rate, may be a too crude a criterion to select foetuses with short- and long-term health risks. Other biophysical measurements, such as foetal blood flow patterns and biochemical parameters, may be helpful in a better selection of these foetuses and infants. Furthermore, different causes of IUGR, e.g. poor maternal nutrition versus insufficient placental function, may not have the same effects on the foetus. The discrepancies in the results of studies on the relationship between IUGR or foetal malnutrition and short- and long-term health risks may be explained by the crudeness of the independent variables used. In the future, research on the biology of the developing human foetus should be more focused in the studies of the relationship between the intrauterine environment and nutrition and risk of poor health later in life.
Institute for Nutrition Research and Department of Obstetrics and Gynecology, University of Oslo, Norway.
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D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005314:Embryonic and Fetal Development / Q000502:physiology*; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology*; D006304:Health Status; D006801:Humans; D007223:Infant; D009664:Norway; D009752:Nutritional Status; D011247:Pregnancy; D011379:Prognosis; D018570:Risk Assessment