Neonatal management of the growth-restricted infant

Semin Fetal Neonatal Med. 2004 Oct;9(5):403-9. doi: 10.1016/j.siny.2004.03.004.


Close collaboration between obstetricians and neonatologists is essential for proper care of the growth-restricted fetus. A joint decision on the appropriate timing of delivery is made, based on the risk of fetal compromise compared with that of neonatal morbidity. A neonatal resuscitative team should be available at delivery. Gestational assessment, anthropological measurements and physical examination are necessary to confirm the diagnosis of intra-uterine growth retardation and establish the symmetric, asymmetric, combined or dysmorphic classification. Neonatal management requires special attention to a number of significant morbidities that growth-restricted infants are more prone to develop compared with normally grown infants, including asphyxia, meconium aspiration syndrome, respiratory distress syndrome, massive pulmonary haemorrhage, chronic lung disease, hypothermia, hypoglycaemia, hypocalcaemia, polycythaemia-hyperviscosity, intraventricular haemorrhage, sepsis, necrotizing enterocolitis, coagulation abnormalities, and congenital anatomical and genetic abnormalities. Intra-uterine growth retardation is associated with a higher stillbirth rate and infant mortality rate in preterm, term and post-term infants.

Publication types

  • Review

MeSH terms

  • Delivery, Obstetric
  • Female
  • Fetal Diseases / etiology
  • Fetal Growth Retardation / complications
  • Fetal Growth Retardation / mortality
  • Fetal Growth Retardation / therapy*
  • Humans
  • Pregnancy