title: Prematurity and fetal growth restriction.
abstract: Assessment of the growth status of the fetus and neonate is an essential component of perinatal care. It requires a distinction to be made between physiological and pathological factors, and the prediction of the optimal growth that a baby can achieve in a normal, uncomplicated pregnancy. Such an individually customised standard can now be easily calculated by computer: it needs to be accurately dated, individually adjusted for physiological characteristics, exclude pathological factors such as smoking, and be based on a fetal weight trajectory derived from normal term pregnancies. Application of a customised standard to calculate the growth status of preterm babies gives us freshly insights into the causes of prematurity. Fetal growth restriction is seen as a strongly associated factor, which is often present before the onset of spontaneous preterm labour. This raises the question whether, in many instances, the initiation of parturition should be seen as a fetal adaptive response aimed at escaping an unfavourable intrauterine environment. These concepts have implications for the understanding of the pathophysiology of preterm labour, as well as its clinical management.
authors.affiliation: Perinatal Institute, Crystal Court, Aston Cross, Birmingham B6 5RQ, United Kingdom. gardosi@perinatal.nhs.uk
authors.forename: Jason O
authors.initials: JO
authors.lastname: Gardosi
mesh_terms: D049628:Body Size; D047109:Fetal Development / Q000502:physiology*; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D016017:Odds Ratio; D047928:Premature Birth / Q000503:physiopathology*