Intrauterine growth restriction: a perspective for Pakistan.
BACKGROUND
Intrauterine growth restriction (IUGR) is the second leading contributor to the prevailing perinatal mortality and morbidity. It affects 23.8% of newborns around the world and 75% of these affected infants are born in Asia. In Pakistan the incidence of IUGR is around 25%, more than the WHO criteria for triggering a public health action.


BACKGROUND
IUGR is implicated with profound long-term impacts in adult life; like coronary heart disease, NIDDM and abnormal cortisol levels. The effects of the short and long term sequelae are reviewed.


BACKGROUND
IUGR is associated with a wide variety of etiological factors. But the factor unique in its importance to Pakistan is maternal malnutrition. The fetal gene expression is under the influence of nutrition. Growth projection curves showing the interaction between the genetic and environmental factors are discussed.
Identification of IUGR baby in a primary care setting and the options in diagnosis in secondary and tertiary care settings are overviewed.


CONCLUSIONS
The roots of this problem, with multi factorial causes are in the socioeconomic infrastructure. This calls for a synergistic approach of reducing this public health issue. Women empowerment can help us to get out of this intergenerational cycle of growth failure. Availability of resources aside, it is also a matter of political will to change things for the better.
Shamim
A
A
Aga Khan University Hospital, Karachi.
Khan
H O
HO
Rana
J S
JS
Ahmed
K A
KA
D005317:Fetal Growth Retardation / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D009748:Nutrition Disorders / Q000150:complications; D010154:Pakistan; D012959:Socioeconomic Factors