Mechanisms of Intrauterine Growth Retardation: Role of Fetal and Maternal Hormones

The clinical importance of intrauterine growth retardation (IUGR) should not be underestimated. There is an association between the degree of IUGR and perinatal morbidity and mortality. Fetuses with IUGR are more likely to be stillborn or die in the neonatal period. Neonates with IUGR have greater risk of asphyxia induced encephalopathy with the consequent risks of neurological dysfunction. Infants who are born small may either show catchup growth or show persistent growth failure. In addition to these immediate consequences, there is increasing suspicion that IUGR may have lifelong consequences. Barker and associates have recently presented considerable evidence linking abnormal fetal and/or placental growth to the subsequent development of hypertension, ischemic heart and cerebrovascular disease in adulthood (Barker and Martyn 1992). At particular risk are infants who are disproportionately small relative to their placentae.