Intrauterine growth restriction (IUGR)

Though genetics and other factors determine the growth and size of the baby during pregnancy and at birth, some babies in the womb grow abnormally smaller than what is normal for his or her gestational age, a condition referred to as intrauterine growth restriction (IUGR). Read on to know the causes, symptoms, diagnosis, complications and treatment of IUGR.

Last Updated: 22 October 2020

Intrauterine growth restriction (IUGR)
Intrauterine growth restriction (IUGR)

Not all babies grow at the same pace during pregnancy nor are born the same size at birth. Some are born larger while others are smaller. The growth of a baby’s size is considered healthy as long as he or she meets the expected size for the respective gestational age.

How is intrauterine growth restriction (IUGR) defined?

When a growing fetus weighs less than 10th percentile of babies of the same gestational age, doctors might suspect a condition called intrauterine growth restriction (IUGR). It requires further diagnosis to confirm the presence of IUGR.

What causes intrauterine growth restriction (IUGR)?

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While there can be several causes of IUGR, here are the primary reasons:

·         Placental failure or insufficiency: Placenta is the main channel of oxygen and nutrients supply to the fetus. Abnormalities in the formation or functioning of placenta can lead to decreased nourishment to the growing baby, resulting in retarded growth.

·         Chromosomal abnormalities: Genetic defects can hinder the normal growth and development of the fetus.

·         Infections: Intrauterine infections or other infections such as cytomegalovirus contracted by the mother before or during pregnancy can affect the growth of the fetus.

·         Smoking and alcohol: Certain lifestyle factors such as smoking, drinking alcohol or taking drugs can have a negative impact on the size of the growing baby.

·         Pregnancy complications: The mother’s health plays an important role in how the baby grows in the womb. Complications during pregnancy such as preeclampsia, high blood pressure, antiphospholipid syndrome or gestational diabetes can interfere with the normal growth of the baby.

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Other causes include taking certain medications during pregnancy, carrying multiples and nutritional deficiency in the mother.    

What are the symptoms of intrauterine growth restriction (IUGR)?

During routine prenatal visits, your doctor will measure your fundal height (the distance between the top of your uterus and top of your pubic bone) which will then be compared with what’s normal at the respective gestational age. If the fetus is abnormally smaller than what is expected, it is often the first symptom of IUGR. However, not all babies who are smaller in size necessarily have IUGR.

Your weight will also be regularly monitored throughout pregnancy. If you are not picking up enough weight for gestational age, it may indicate a problem with the baby’s growth, though it is not always the case.

Some pregnant mothers will be able to identify changes in the baby’s movements. The baby might move less frequently than what he or she used to earlier. Contact your healthcare provider immediately if you suspect changes in baby’s movements.

Based on the symptoms, your doctor would advise further diagnosis in order to confirm IUGR.

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How is IUGR diagnosed?

If your doctor suspects IUGR Based on the fundal height measurement, you will be advised to do an ultrasound. During the scan, your doctor will be able to assess if your baby’s size is small, and if the placenta and umbilical cord are in good health. If a discrepancy in the growth of the baby is observed through the ultrasound, you may have to run a Doppler flow to check the flow of blood through the umbilical cord and the baby’s brain. Additional tests such as fetal monitoring and amniocentesis may be advised to check for the presence of intrauterine growth restriction.

What are the complications of intrauterine growth restriction (IUGR)?

Intrauterine growth restriction may increase the chances for the following complications:

·         Impaired growth of the baby

·         Low birth weight

·         Premature delivery

·         C-section delivery

·         Susceptible to infections

·         Low APGAR score

·         Issues in maintaining normal body temperature

How is IUGR treated?


There is no specific treatment for IUGR. Most often, pregnancy care which is recommended for a healthy pregnancy such as balanced nutrition intake, enough rest and regular antenatal visits are what will be suggested. Your doctor will decide if you need safe medications during pregnancy to accelerate your baby’s growth. In some cases of intrauterine growth restriction, your baby might have to be taken out earlier than the actual due date 

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