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Infants with fetal (intrauterine) growth restriction

George T Mandy, MD
Section Editor
Leonard E Weisman, MD
Deputy Editor
Melanie S Kim, MD


Infants with fetal growth restriction (FGR; also referred to as intrauterine growth restriction) who did not achieve full in utero growth potential because of genetic or environmental factors are at increased risk for significant morbidity and mortality compared with infants with normal in utero growth.

The clinical features, complications, and management of infants born with FGR are discussed here. The diagnosis, evaluation, and management of FGR during pregnancy are discussed separately. (See "Fetal growth restriction: Diagnosis" and "Fetal growth restriction: Evaluation and management".)


Several terms have been used to describe infants with low birth weights (BW) for their gestational age. These include small for gestational age (SGA) and fetal (intrauterine) growth restriction (FGR). These two terms, although related since they may include many of the same infants, are not the same.

Small for gestational age — Small for gestational age (SGA) is defined as infants with a BW below the 10th percentile for gestational age (table 1) [1]. However, this definition does not make a distinction among SGA infants who are constitutionally normally small from those who are growth-restricted and small. Constitutionally small infants are those with a normal BW below 10th percentile due to constitutional factors including maternal height, weight, ethnicity, and parity. These infants are not at increased risk for perinatal mortality or morbidity [1].

Fetal growth restriction — Fetal growth restriction (FGR) refers to the fetus who does not achieve the expected in utero growth potential due to genetic or environmental factors (table 2). It is defined as an estimated fetal weight <10th percentile (see "Fetal growth restriction: Diagnosis", section on 'Definition'). Clinically, most infants with FGR are identified because they are born SGA with a BW below the 10th percentile for gestational age (table 1). Moderate FGR is defined as BW in the 3rd to 10th percentile, and severe FGR as less than the 3rd percentile.

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Literature review current through: Sep 2017. | This topic last updated: Sep 20, 2017.
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