BACKGROUND:
Fetal growth restriction (FGR) has been related to several health risks, which have been generally identified in small-for-gestational age (SGA) individuals. OBJECTIVE: To evaluate the impact of FGR on body composition and
hormonal status in infants born either small- or appropriate-for-gestational age (AGA). METHODS:
Fetal growth was assessed by
ultrasound every 4 weeks from mid-gestation to birth in 248 high-risk
pregnancies for SGA.
Fetal growth velocity was calculated as change in the estimated
fetal weight percentiles and FGR defined as its reduction by more than 20
percentiles from 22
gestational weeks to birth. Impact of FGR on body composition, cord
insulin,
IGF-I, IGF binding protein-3 (IGFBP-3), and
cortisol concentrations was assessed in SGA and AGA newborns. Results: Growth-retarded AGA infants showed significantly reduced
birth weight, ponderal index, percentage of fat mass, and
bone mineral density when compared with AGA newborns with stable intrauterine growth. Cord
IGF-I and IGFBP-3 concentrations were significantly decreased in growth-retarded infants in both SGA and AGA groups. Cord
insulin concentration was significantly lower and cord
cortisol significantly higher in AGA infants with FGR versus AGA newborns with stable intrauterine growth. After adjustment for
gestational age and gender,
birth weight was directly related to
fetal growth velocity and cord
IGF-I concentration. The variation in infant's
adiposity was best explained by
fetal growth velocity and cord
insulin concentration. CONCLUSIONS: FGR affects body composition and
hormonal parameters in newborns with
birth weight within the normal range, suggesting these individuals could be at similar
metabolic risks as SGA. .
