Intrauterine Growth Retardation and Its Influence on Further Development of Extremely Immature Newborns

Czech version

Authors: M. Fedorová ¹; B. Zlatohlávková ¹; J. Kytnarová ²; G. Malošková ¹; M. Kršek ³; R. Plavka ¹
Authors‘ workplace: Gynekologicko-porodnická klinika VFN a UK 1. LF, Praha přednosta prof. MUDr. A. Martan, DrSc. ¹; Klinika dětského a dorostového lékařství VFN a UK 1. LF, Praha přednosta prof. MUDr. J. Zeman, DrSc. ²; III. interní klinika VFN a UK 1. LF, Praha přednosta prof. MUDr. Š. Svačina, DrSc., MBA ³
Published in: Čes-slov Pediat 2009; 64 (7-8): 359-364.
Category: Review

Overview

Severe immaturity and intrauterine growth retardation pose risk factors not only for inadequate postnatal adaptation but also for many diseases developed in adulthood. Chronic stress throughout the intrauterine growth leads to the development of many metabolic, endocrine and hemodynamic changes and concurrently accelerates maturation of several organ systems. These changes might represent short term advantage for prematurely born infant giving him higher probability of survival in immediate postnatal period.

In the later development, however, these pathologically programmed metabolic and endocrine derangements may cause or worsen the development of many diseases primarily induced by immaturity (respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage and retinopathy of prematurity). Intrauterine metabolic changes may as well represent the basis for metabolic syndrome and cardiovascular morbidity later in the adult age. Insulin-like growth factors (IGF-I, IGF-II and their binding proteins (IGFBPs)) appear to be suitable monitoring system of metabolic changes in the course of therapy of extremely low birth weight infants.

Key words:
extremely low birth weight infant, intrauterine growth retardation (IUGR), insulin-like growth factors IGF-I and IGF-II, insulin-like growth factors binding proteins (IGFBPs)

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Article was published in

Czech-Slovak Pediatrics

2009 Issue 7-8