Causes and consequences of intrauterine growth retardation in Latin America.

The purpose of this article is to present a critical review of the literature on the causes and consequences of intrauterine growth retardation (IUGR) and of body proportions at birth among IUGR infants. IUGR is generally defined as a birth weight below the tenth percentile of a reference weight distribution according to gestational age. Chronic maternal malnutrition and other poverty-related factors are likely to be important determinants of IUGR in developing countries. IUGR has been associated with increased risks of neonatal morbidity and mortality and alterations in physical and mental development during early childhood. IUGR newborns can be classified as "symmetric" or "asymmetric" in terms of body proportionality. The available literature indicates that the risk of perinatal morbidity is higher among asymmetric newborns than among their symmetric counterparts, while symmetric newborns confront a higher risk of impaired physical and mental development. Obviously, the clinical and statistical usefulness of these IUGR and body proportionality assessments depends on the accuracy of the birth measurements (length, weight, and estimated gestational age) from which they are derived. Latin America now has the hospital infrastructure needed to obtain reliable birth data of this kind. It is important to use these resources effectively in order to improve the health assessment of newborns and gain a better understanding of the causes and consequences of IUGR.