Dr. MJ Bazos MD,
Restriction: When Your Baby Stops Growing Before Birth
What is intrauterine growth
Intrauterine growth restriction ("IUGR," for
short) is a term for a baby who is smaller than normal during pregnancy. The
baby is not growing inside the uterus at the normal rate. These babies usually
have a low weight at birth.
What causes IUGR?
IUGR has various causes. The most common cause
is a problem in the placenta (the tissue that carries food and blood to the
baby). Birth defects and genetic disorders can cause IUGR. If the mother has an
infection, high blood pressure, is smoking, or drinking too much alcohol or
abusing drugs, her baby might have IUGR. Sometimes a prescribed medicine that
the mother is taking causes IUGR.
Did I cause this problem?
Most of the causes of IUGR are beyond your
control. Usually, nothing the mother did causes IUGR in her baby. But if you
smoke cigarettes, drink alcohol or abuse drugs, you can cause IUGR in your baby.
Do all small babies have IUGR?
No. About one- third of the babies who are small
at birth have IUGR. The rest of them don't have IUGR--they're just smaller than
normal. Just like there are different sizes of infants, children and adults,
there are also different sizes of babies in the uterus. Small babies tend to run
in families. The parents or other children in the family may have been small
when they were born, too.
How will I know if my baby is just
small or has IUGR?
During your pregnancy, your doctor will do tests
to find out if your baby is growing normally. The main test for checking a
baby's growth in the uterus is an ultrasound. The ultrasound exam lets your
doctor "see" your baby in your uterus with an instrument that is moved across
your abdomen (belly).
When the ultrasound
exam is done, your doctor will measure the size of your baby's head, abdomen and
legs. These measurements will tell you and your doctor if your baby is growing
normally. Your doctor will also find out the amount of amniotic fluid in your
uterus. In some babies with growth restriction, the amount of amniotic fluid is
low. If your baby is small, ultrasound exams may be done more often than usual
to check your baby's health.
Are there other tests I might have?
One test is fetal monitoring. It's a way to
check your baby's health inside your womb. Straps are put over your uterus as
you lie down for about 30 minutes. You will hear your baby's heart beat as it is
recorded. Your doctor can look at the heartbeat recording and see if your baby's
heartbeat is normal.
You might also have
an amniocentesis. A needle is put through your stomach area into your uterus. A
few teaspoons of amniotic fluid are withdrawn in the needle. The fluid is tested
to see if it shows the cause of the IUGR. The amniotic fluid might show genetic
problems or infection.
If my baby has IUGR, will I have to
give birth early?
Maybe not. The time of delivery depends on how
well your baby is doing. Sometimes, babies with IUGR keep on growing in the
uterus. If your baby keeps gaining some weight, an early delivery (before the
due date) may not be needed. But if your baby is not growing at all or has other
problems, your doctor may decide that an early delivery could help. In this
case, your doctor may want to induce labor. Your baby's heart rate and movements
will be closely watched to help you and your doctor make this decision.
Will I need to have a cesarean
If there are no signs of problems with your baby
during labor, a vaginal delivery is OK. Some babies with IUGR are weak. The
stress of labor and delivery may be too much for a weak baby. If your baby has
problems during labor, a cesarean section (also called a C section) may be
If I have another baby, will that
baby also have IUGR?
Generally, no. IUGR usually doesn't occur in
another pregnancy. But in some women, it does happen again. Women who have
another pregnancy affected by IUGR usually have an illness, such as
hypertension, that causes IUGR. Good control of illnesses before and during
pregnancy lowers the risk of having another baby with IUGR.
Will my baby need to stay in the
hospital longer than usual?
Probably, especially if your baby was born
early. Babies who are small at birth need to stay in the hospital until they can
breathe and feed normally. After your baby is born, the doctor will check your
baby's weight to make sure the baby is growing. Generally, babies stay in the
hospital until they weigh about 5 pounds and can breathe and feed normally.
Will my baby grow up to be normal in
Yes. Your baby will probably catch up in size
and have a normal height by about 2 years of age.
What can I do to help my baby while
The best way to help your baby is to pay
attention to your baby's movements. Make sure your baby is moving every day. A
baby who moves around often is usually healthy. A baby who doesn't move very
often or who stops moving may be sick. If you notice your baby isn't moving as
much, call your doctor.
Another way you
can help your baby is to get a lot of rest. Rest may help you feel better. It
may even help your baby grow. Try to get 8 hours of sleep (or more) each night.
An hour or 2 of rest in the afternoon is also good for you. Your doctor may even
want you to go to the hospital to make sure you rest. The hospital staff will
keep a close eye on you and your baby.
Finally, if you smoke, drink alcohol or
use drugs, stop now. These things can hurt your baby. This may be all that is
needed to improve your baby's health, as well as your own.