|
Origin | Risk factors |
|
Maternal causes | |
|
Medical conditions | |
|
(i) Vascular diseases | Chronic hypertension |
Preeclampsia early in gestation |
Diabetes mellitus |
Systemic lupus erythematosus |
Chronic kidney disease |
Inflammatory bowel disease |
Severe lung disease |
(ii) Infections | Syphilis |
Toxoplasmosis |
Cytomegalovirus |
Rubella virus |
Hepatitis B virus |
Herpes simplex virus 1 or 2 |
HIV-1 |
Helicobacter pylori |
Malaria |
|
Social conditions | |
|
(i) Malnutrition | Low prepregnancy weight and small maternal size |
Poor weight gain during pregnancy, especially in latter half |
Nutritional deficiencies: protein folic acid, vitamin A, B, C, zinc, calcium |
(ii) Drugs use | Cigarettes, alcohol, heroin, cocaine |
Teratogens, antimetabolites, and therapeutic agents such as trimethadione, warfarin, and phenytoin |
(iii) History | Recent pregnancy and/or high parity |
Multiple pregnancy |
Prior history of IUGR pregnancy |
Residing at altitude over 5,000 ft (1,500 m) |
|
Fetal Causes | |
|
Genetic factors | Race, ethnicity, nationality, sex parity (primiparous, weigh less than subsequent siblings), genetic disorders (Achondroplasia, Russell-Silver syndrome) |
Chromosomal anomalies | Chromosomal deletions |
Trisomy 13,18, and 21 |
Congenital malformations | Anencephaly, GI atresia, Potter’s syndrome, and pancreatic agenesis |
|
Placental Causes | |
|
Placental insufficiency | Reduced blood flow |
Anatomic problems | Multiple infarcts |
Aberrant cord insertions |
Umbilical vascular thrombosis and hemangiomas |
Premature placental separation |
Small Placenta |
|