[Prevention of IUGR].
OBJECTIVE
Prevention of intrauterine growth restriction (IUGR) should be addressed before conception ideally for all women, or at least for those with a medical risk factor or with a history of poor perinatal outcome or obstetrical complication. The aim of this section is to assess available evidence on IUGR prevention and elaborate clinical guidelines.


METHODS
Bibliographic research on PubMed and Cochrane Database.


RESULTS
Maternal age above 40 increases the risk of IUGR (Experts opinion). Encouraging women to start pregnancy when their Body Mass Index (BMI) is between extremes (grade B) and aiming for recommended weight gain according to their preconceptional BMI (professional consensus) reduce the risk of IUGR. When possible, avoiding multiple pregnancies (grade A), stabilizing chronic diseases that can influence placenta vascularization (professional consensus), stopping smoking as soon as possible before or at the beginning of pregnancy (grade A), limiting hypoglycemia during pregnancy (grade C) and tolerating mild maternal hypertension throughout pregnancy (professional consensus) also limit the risks of IUGR. In women with a prior preeclampsia<34 WG or an IUGR <5th centile due to placental dysfunction, aspirin given ideally in the second part of the day (grade B) can be a useful option and should be started before 16 WG (grade A).


CONCLUSIONS
There are few methods to prevent IUGR, and some simple recommendations seem useful. Aspirin seems a useful option in women identified as at risk of IUGR. More research is needed on prevention of IUGR.
Service de gynécologie obstétrique hôpital Pitié-Salpêtrière, AP-HP, UPMC Paris-6, 83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: jacky.nizard@psl.aphp.fr.
J
J
Nizard
D001835:Body Weight; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D012907:Smoking / Q000009:adverse effects
Aspirin; Aspirine; Grossesse; Intrauterine growth restriction; Pregnancy; Prevention; Prévention; Retard de croissance intra-utérin