Prada J A, Tsang R C
Children's Hospital Medical Center, Cincinnati, Ohio 45267-0541, USA.
Eur J Clin Nutr. 1998 Jan;52 Suppl 1:S21-7; discussion S27-8.
The causes of intrauterine growth retardation (IUGR) are multiple, involving many different factors. Studies in humans and animals have shown that the maternal environment is the most important determinant of newborn weight, accounting for more similarity in birth weights of siblings than does genetic affinity. In addition to a direct relationship with the degree of maternal plasma volume expansion, many clinical factors are associated with IUGR. These factors include multiple gestation; fetal, genetic, and chromosomal anomalies (Down's syndrome and Turner's syndrome); infections such as TORCH syndrome (acronym for toxoplasmosis, rubella, cytomegalic disease, and herpes); and various maternal disorders including anemia, severe chronic asthma, chronic renal disease, heart disease and hypertension. Maternal stress factors, including narcotic addiction, cigarette smoking and chronic alcoholism, are associated with IUGR. Placental anomalies including hemangiomas, placental infarcts, single umbilical artery, and small placental size are also associated with intrauterine growth retardation. Poor nutritional status of the mother at conception and inadequate energy and protein intakes during pregnancy can also result in IUGR. Because IUGR children are not a homogeneous group, they have a broad spectrum of growth, health, and developmental outcomes. In general they have higher rates of subnormal growth, morbidity, and neurodevelopmental problems. The biomedical mechanisms reflected in nutritional, infection-related, hormonal, and metabolic parameters are not likely to be independent causative factors of IUGR, but important mediating factors of a pathologic process set in motion by other agents and insults. This paper focuses mainly on the possible negative effects that a deficient maternal diet might have on fetal development and growth.
宫内生长受限（IUGR）的病因是多方面的，涉及许多不同因素。对人类和动物的研究表明，母体环境是新生儿体重的最重要决定因素，其对兄弟姐妹出生体重相似性的影响大于遗传亲和力。除了与母体血容量扩张程度直接相关外，许多临床因素也与IUGR有关。这些因素包括多胎妊娠；胎儿、遗传和染色体异常（唐氏综合征和特纳综合征）；感染，如TORCH综合征（弓形虫病、风疹、巨细胞病和疱疹的首字母缩写）；以及各种母体疾病，包括贫血、严重慢性哮喘、慢性肾病、心脏病和高血压。母体应激因素，包括药物成瘾、吸烟和慢性酒精中毒，也与IUGR有关。胎盘异常，包括血管瘤、胎盘梗死、单脐动脉和胎盘小，也与宫内生长受限有关。母亲受孕时营养状况不佳以及孕期能量和蛋白质摄入不足也可导致IUGR。由于IUGR儿童并非同质群体，他们在生长、健康和发育方面有广泛的结果。一般来说，他们生长发育迟缓、发病和神经发育问题的发生率较高。营养、感染相关、激素和代谢参数所反映的生物医学机制不太可能是IUGR的独立致病因素，而是由其他因素和损伤引发的病理过程的重要介导因素。本文主要关注母体饮食不足可能对胎儿发育和生长产生的负面影响。
