Aetiology and pathogenesis of IUGR

Best Pract Res Clin Obstet Gynaecol. 2009 Dec;23(6):765-77. doi: 10.1016/j.bpobgyn.2009.05.003. Epub 2009 Aug 8.


Intrauterine growth restriction (IUGR) is a major cause of perinatal mortality and morbidity. A complex and dynamic interaction of maternal, placental and fetal environment is involved in ensuring normal fetal growth. An imbalance or lack of coordination in this complex system may lead to IUGR. Animal studies have given us an insight into some aspects of the basic pathophysiology of IUGR, and recent technologies such as Doppler studies of maternal and fetal vessels have added further information. The aetiologies of IUGR are diverse, involving multiple complex mechanisms, which make understanding of the pathophysiology difficult. However, particular focus is placed on the mechanisms involved in uteroplacental insufficiency as a cause of IUGR, as (1) it is common, (2) outcome can be good if timing of delivery is optimal and (3) it may be amenable to therapy in the future. While the research into the pathophysiology of IUGR continues, there have been interesting discoveries related to the genetic contribution to IUGR and the intrauterine programming of adult-onset diseases attributed to IUGR.

Publication types

  • Review

MeSH terms

  • Brain Diseases / embryology
  • Cardiovascular Diseases / embryology
  • Endocrine System Diseases / embryology
  • Female
  • Fetal Development / physiology*
  • Fetal Growth Retardation / etiology*
  • Gastrointestinal Diseases / embryology
  • Genetic Diseases, Inborn / embryology
  • Gestational Age
  • Humans
  • Kidney Diseases / embryology
  • Lung Diseases / embryology
  • Muscular Diseases / embryology
  • Placenta Diseases / physiopathology
  • Placental Circulation / physiology
  • Pregnancy
  • Pregnancy Complications, Infectious / physiopathology
  • Prenatal Exposure Delayed Effects / etiology
  • Prenatal Nutritional Physiological Phenomena / physiology