Defining normal and abnormal fetal growth: promises and challenges

Am J Obstet Gynecol. 2010 Jun;202(6):522-8. doi: 10.1016/j.ajog.2009.10.889. Epub 2010 Jan 13.


Normal fetal growth is a critical component of a healthy pregnancy and influences the long-term health of the offspring. However, defining normal and abnormal fetal growth has been a long-standing challenge in clinical practice and research. We review various references and standards that are used widely to evaluate fetal growth and discuss common pitfalls of current definitions of abnormal fetal growth. Pros and cons of different approaches to customize fetal growth standards are described. We further discuss recent advances toward an integrated definition for fetal growth restriction. Such a definition may incorporate fetal size with the status of placental health that is measured by maternal and fetal Doppler velocimetry and biomarkers, biophysical findings, and genetics. Although the concept of an integrated definition appears promising, further development and testing are required. An improved definition of abnormal fetal growth should benefit both research and clinical practice.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Female
  • Fetal Development / physiology*
  • Fetal Growth Retardation / diagnosis*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age / growth & development*
  • Pregnancy
  • Reference Values