Classification of intrauterine growth retardation.

Abstract

0 NLY WITHIN the last 25 years has the historical observation (survival is less likely in babies born too small) evolved into the concept of a poorer prognosis for babies with impaired growth. In the late 17th and 18th centuries, the most renowned obstetricians such as Mauriceau in France and Snellie in England estimated birth weights as high as 15 to 16 lb. A review of this historical literature by Cone’ notes that weights and measures were established for purposes of trade. One could wonder if these early physicians borrowed the weights from local merchants whose pounds might have been underweight. During the early 20th century, physicians gradually became more aware of the difference between diminished growth and prematurity, important because these two problems lead to somewhat different ranges of complications and long-term sequelae. In 1961 the Expert Committee on Maternal and Child Health* recommended that the low birthweight (BW) be applied to infants weighing less than 2,500 g, regardless of gestational age. This has been used to gather worldwide statistics in which gestational age, other detailed information about pregnancies, and specifics as to newborn evaluations has been less than adequate. The gathering of more detailed information about various populations has enabled more specific evaluation of fetal growth and birthweight with regards to gestational age. Low birthweight infants may be further divided into three classes3,4: (1) neonates who are appropriate for gestational age, delivered before 37 weeks gestation (preterm neonate). (2) Neonate, who is small for gestational age, delivered before 37 weeks gestation (preterm and growth retarded neonate). (3) Neonate, who is small for gestational age, delivered after 37 weeks gestation (term growth retarded neonate), which constitutes 33% of all low birthweight infants.5