What happens if your baby doesn't grow inside you the way he/she is supposed to? This is a condition called intrauterine growth restriction (IUGR). Babies with IUGR are much, much smaller than other babies of the same gestational age.
If severe, IUGR can pose big risks to your baby. Fortunately, with regular prenatal checkups, your doctor can spot this problem if it occurs and you can take steps to reduce the impact on your baby. You can't always prevent IUGR. But a healthy lifestyle will go a long way toward reducing your risks.
How Can It Affect My Baby and Me?
Mild IUGR usually doesn't cause long-term problems. In fact, most babies with IUGR catch up in height and weight by age 2. But if severe, IUGR can seriously harm a baby before and after birth. The extent of the health problems depends upon the cause and severity of the growth restriction. It also depends upon how far along you are in the pregnancy when it develops.
With IUGR, your baby is more likely to have:
- Trouble handling the stress of vaginal delivery
- Meconium aspiration, a condition in which a baby inhales meconium (baby's first stool in the womb)
- A premature birth and low birth weight
- Low blood sugar
- Less resistance to infection
- Poor control of body temperature after birth
- Long-term developmental and physical disabilities or medical problems
Although rare, some babies with severe IUGR die before delivery.
Who Is at Risk for IUGR?
Many factors can influence a baby's growth during pregnancy, including:
- A problem with the placenta, which causes decreased blood flow to the baby
- Birth defects or genetic abnormalities
- Health problems in the mom-to-be, such as certain viral infections, blood pressure problems, cardiovascular disease, autoimmune disease, advanced diabetes, sickle cell anemia, and chronic kidney disease
- Lifestyle factors, such as smoking, drinking alcohol, illegal drug use, poor nutrition, or obesity
- Living at an altitude above 5,000 feet
Screening for IUGR
Beginning around 24 weeks, your doctor will measure your baby at each of your prenatal checkups. It's possible to tell the general size of your baby by measuring the distance between your pubic bone and the top of the uterus. Then your doctor compares this to other babies of the same age.
Your doctor may suggest an ultrasound to more accurately assess your baby's weight if:
- Measurements at prenatal checkups are very small
- You have risk factors for IUGR
- You had a previous baby with growth restriction
An ultrasound allows your doctor to:
- See your baby inside your uterus
- Measure your baby's body parts
Your doctor may suspect IUGR if your baby is less than the 10th percentile for his or her gestational age.
If the Diagnosis Is IUGR
If your baby has IUGR, you will undergo more exams to monitor your baby's health.
You may have several ultrasounds to check:
- Your baby's growth and movement
- Placental blood flow
- Amount of amniotic fluid
You may also need:
- A non-stress test to evaluate your baby's heartbeat/well being
- Doppler flow studies to test blood flow through the umbilical cord and in the vessels in the fetal brain
- Amniocentesis (amnio) to check for infection or chromosomal abnormalities
- Blood tests to check for infections or other health problems
You can help monitor the health of your baby by paying close attention to your baby's movement. If you feel your baby moving around a lot, he or she is probably doing fine.
However, tell your doctor right away if:
- You notice a lack of movement
- Your baby becomes less active than normal
If your doctor decides that your baby has stopped growing or his or her life is at risk, you will need to deliver your baby early. Your baby will need to stay in the hospital until he or she can breathe and feed normally and is able to regulate his or her body temperature.