Romo Agustín, Carceller Raquel, Tobajas Javier
Fetal Medicine Unit, "Miguel Servet" University Children's Hospital, Zaragoza, Spain.
Pediatr Endocrinol Rev. 2009 Feb;6 Suppl 3:332-6.
Intrauterine growth retardation (IUGR) is mainly due to a pathologic slow-down in the fetal growth pace, resulting in a fetus that is unable to reach its growth potential. IUGR frequency will vary depending on the discrimination criteria adopted. It is extremely important to use local or national fetal growth graphs in order to avoid some confounding factors. IUGR incidence in newborns would be between 3% and 7% of the total population. In our experience it is 5.13% a figure similar to the one obtained by other authors but with a progressively higher incidence during the last decade. There are multiple maternal factors that can generally be grouped into constitutional and general factors given that they affect age, weight, race, maternal cardiac volume, etc, socioeconomic factors with key incidence in the mother's nutrition level, where a poor maternal nutrition level would be the key factor in this group. We have evaluated multiple factors as possible contributors to the IUGR risk: race, parents' age, mother's height (cm), mother's birth weight and before pregnancy (kg), ponderal gain and blood pressure during pregnancy, and previous SGA newborns. Socioeconomic factors like social class, parents' profession, habitual residence, salary, immigration, and diet were also evaluated. We also included variables such as total daily working time and time mothers spent standing up, daily sleeping time (hrs), stress self-perception test at work and primiparity age. Toxic factors during pregnancy: tobacco (active and passive), alcohol, drugs and coffee consumption. Fetal or utero-placental factors were considered. In our study, the most significant etiologic factors were: Active and passive tobacco consuming, mother's stress level, increase of total months worked during pregnancy, total daily working hours and time mothers spent standing up and finally, the parent's height. Our data support the main objective of reducing the incidence of SGA newborns after IUGR by fighting against tobacco from all fields, including the passive smoking habit, and improving the laboral conditions of the pregnant mother, lowering the number of daily hours worked, the physical activity and trying to avoid and to cope with stressful situations.
宫内生长受限（IUGR）主要是由于胎儿生长速度病理性减缓，导致胎儿无法发挥其生长潜力。IUGR的发生率会因所采用的判别标准而异。使用当地或国家胎儿生长图表以避免一些混杂因素极为重要。新生儿中IUGR的发生率在总人口的3%至7%之间。根据我们的经验，这一比例为5.13%，与其他作者得出的数字相似，但在过去十年中发生率呈逐渐上升趋势。有多种母体因素，通常可分为体质和一般因素，因为它们会影响年龄、体重、种族、母体心容量等，社会经济因素在母亲营养水平方面具有关键影响，其中母体营养水平差是该组中的关键因素。我们评估了多种可能导致IUGR风险的因素：种族、父母年龄、母亲身高（厘米）、母亲出生体重及孕前体重（千克）、孕期体重增加和血压，以及既往小于胎龄儿新生儿。还评估了社会经济因素，如社会阶层、父母职业、常住地、薪资、移民和饮食。我们还纳入了一些变量，如每日总工作时间、母亲站立时间、每日睡眠时间（小时）、工作压力自我感知测试和初产年龄。孕期的有毒因素：吸烟（主动和被动）、饮酒、吸毒和咖啡摄入量。还考虑了胎儿或子宫 - 胎盘因素。在我们的研究中，最显著的病因因素是：主动和被动吸烟、母亲的压力水平、孕期工作总月数增加、每日总工作小时数和母亲站立时间，最后是父母的身高。我们的数据支持通过在各个领域抵制烟草（包括被动吸烟习惯）以及改善孕妇的劳动条件，减少每日工作小时数、体力活动并尽量避免和应对压力情况，来降低IUGR后小于胎龄儿新生儿的发生率这一主要目标。
