14.1. NEWBORNS WITH INTRAUTERINE GROWTH
RESTRICTION
The term intrauterine growth restriction (IUGR) is applied to a newborn whose weight at birth is lesser than 10% percientile ofexpected for the given gestational age.
14.1.1. Epidemiology
IUGR is regarded as a pressing issue in perinatology and pediatrics. The incidence rate of IUGR is 3-17.6%; in pre-term infants IUGR is seen more often: 15.7-22%. In the structure of perinatal morbidity 20% are unrecognized IUGR cases. Infants with IUGR are classified at risk for a short, «miserable» life.
Infants with IUGR require special attention of a neonatologist, pediatrician, psy-choneurologist and other practitioners.
Low body weight is a consequence of multiple causes: his parents' genetic code, ethnic and constitutional features; in these cases the condition of the fetus and newborn is not compromised, and no consideration to IUGR is given.
14.1.2. Classification
ICD-10 codes
• P05.2 Fetal malnutrition without mention of light or small for gestational age (Infant, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin and loss of subcutaneous tissue).
• P05.9 Slow fetal growth, unspecified.
Slow fetal growth should not be confused with IUGR. Slow fetal growth describes the condition of a fetus while IUGR describes a condition after delivery and refers to the newborn infant.
14.1.3. Diagnostics of intrauterine growth restriction in newborns
On their first day of life all newborns are evaluated against scales of physical development. They include such parameters as body weight and length, head circumference in correlation with the gestational age (Fig. 14.1).
The main diagnostic criterion of IUGR is the body weight and other parameters of the newborn's physical development below 10th percentile on the evaluation scale.