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Fetal growth restriction is most often caused by a problem with transport of nutrients and oxygen from the mother’s blood to the baby, via the placenta. Inadequate blood flow to the placenta in the uterine arteries is the underlying abnormality in many cases. This is called utero-placental insufficiency.
Occasionally fetal growth restriction is caused by other problems including structural problems (the baby’s organs don’t develop properly), aneuploidy (the baby has an abnormal number of chromosomes), virus infections from the mother that cross the placenta and medical problems which the mother suffers from.
At the moment pregnancies affected by fetal growth restriction are monitored carefully by ultrasound scan if the condition is detected, but as yet there is no treatment to help the babies grow.
What is Fetal Growth Restriction (FGR)?
Most pregnancies are uncomplicated but some babies struggle to grow in the womb. This is called fetal growth restriction. Fetal growth restriction affects 8 out of 100 pregnancies, and approximately 60,000 babies per year in Europe and the USA are born with severe fetal growth restriction. Many of these premature, very small babies stay in hospital for months after birth, which is stressful for parents and very costly; neonatal intensive care costs approximately £1,500 per day.
Fetal growth restriction contributes to over half of all stillbirths, which adds up to 1.46 million worldwide each year. Babies born from growth restricted pregnancies are not only at increased risk of perinatal death and complications such as cerebral palsy, but there are long term consequences for their health which include diabetes and cardiovascular disease. In a third of cases it is associated with pre-eclampsia, a condition which causes the mother to have high blood pressure and protein in the urine and can make her seriously ill.
Severe early onset fetal growth restriction occurs in one case out of 500. Here the baby’s growth greatly slows down or even stops very early, often just over halfway through the pregnancy. Once severe early onset fetal growth restriction is identified in mid pregnancy, couples currently face a stark choice between delivering their baby very prematurely in the knowledge that they might die in the neonatal intensive care unit, or allowing the pregnancy to continue with the strong likelihood that the baby will die in the womb.