Screening for intrauterine growth retardation in late pregnancy.

A prospective study was performed on an unselected area-based population in order to improve the antenatal diagnosis of intrauterine growth retardation (IUGR). The clinical importance of simple clinical tests to follow fetal growth (measurements of the symphysis-fundus (SF) distance and recordings of maternal pregnancy weight gain) was investigated. Risk factors for IUGR, appearing in late pregnancy (vaginal bleeding, non-proteinuric pregnancy hypertension and pre-eclampsia) were also studied. A pathological SF curve (frequency 3.5%) was found to be valuable, but mainly as a screening instrument rather than a diagnostic tool for IUGR. Pre-eclampsia was the only risk factor appearing in late pregnancy that could be associated with IUGR. Previously we have recommended early pregnancy screening for the following high risk factors for IUGR: smoking, previous birth of a low birth weight infant, low pre-pregnancy weight, renal disease and addiction. When also screening for pre-eclampsia, 22% of the population exhibited at least one screening factor. Retrospectively we identified all severely growth-retarded infants (birth weight for gestational age less than or equal to -2 S.D.) born in 1980 (n = 27). 23 of these infants were delivered to mothers exhibiting high-risk factors for IUGR or a pathological SF curve. In this way a high-risk group for IUGR can be identified, which should be monitored more carefully during the last period of pregnancy.