Neonatal Morbidities of Fetal Growth Restriction: Pathophysiology and Impact
Open accessAbstract
Being born small lays the foundation for short-term and long-term implications for life. Intrauterine or fetal growth restriction describes the pregnancy complication of pathological reduced fetal growth, leading to significant perinatal mortality and morbidity, and subsequent long-term deficits. Placental insufficiency is the principal cause of FGR, which in turn underlies a chronic undersupply of oxygen and nutrients to the fetus. The neonatal morbidities associated with FGR depend on the timing of onset of placental dysfunction and growth restriction, its severity, and the gestation at birth of the infant. In this review, we explore the pathophysiological mechanisms involved in the development of major neonatal morbidities in FGR, and their impact on the health of the infant. Fetal cardiovascular adaptation and altered organ development during gestation are principal contributors to postnatal consequences of FGR. Clinical presentation, diagnostic tools and management strategies of neonatal morbidities are presented. We also present information on the current status of targeted therapies. A better understanding of neonatal morbidities associated with FGR will enable early neonatal detection, monitoring and management of potential adverse outcomes in the newborn period and beyond.
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Intrauterine growth restriction, low birth weight and reduced fetal viability, including stunted growth and cognitive development in children, have been observed in association with chronic disease in adulthood.
“Intrauterine growth restriction, low birth weight and reduced fetal viability, including stunted growth and cognitive development in children, have been observed in association with chronic disease in adulthood [176, 177].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [176]
The Perinatal Morbidities section links fetal growth restriction to stillbirth, the Neurological Morbidity section reports cognitive impairment in children, and the Cardiovascular Morbidity section links low birth weight and growth restriction to disease in adulthood. The Overview describes stunted fetal growth, but the passages do not establish stunted growth in children or link the childhood cognitive outcomes themselves to adult chronic disease. Our copy provides no page numbers for these sections. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThis can lead to fetal hypoxia, growth restriction and developmental problems.
“This can lead to fetal hypoxia, growth restriction and developmental problems [176].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [176]
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Self-citationVentilation-induced lung injury is not exacerbated by growth restriction in preterm lambs
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Self-citationPrethreshold retinopathy in premature infants with intrauterine growth restriction
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Partial pulmonary embolization disrupts alveolarization in fetal sheep
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Self-citationEffect of Antenatal Steroids on Haemodynamics in the Normally Grown and Growth Restricted Fetus
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Self-citationScreening investigations in small-for-gestational-age near-term and term infants
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Placenta: an old organ with new functions
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Altered trajectory of neurodevelopment associated with fetal growth restriction
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Self-citationExosomes-Associated DNA—New Marker in Pregnancy Complications?
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Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses
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Adiponectin as a Potential Biomarker for Pregnancy Disorders
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Current update on malaria in pregnancy: a systematic review
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Alterations in the Gut Microbiome and Metabolisms in Pregnancies with Fetal Growth Restriction
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Interventions for placental insufficiency and fetal growth restriction
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Neurovascular effects of umbilical cord blood-derived stem cells in growth-restricted newborn lambs
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Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction
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microRNA signatures associated with fetal growth restriction: a systematic review
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Maternal and neonatal complications in women with medical comorbidities and preeclampsia
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Self-citationEndothelial dysfunction in preterm infants: The hidden legacy of uteroplacental pathologies
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Bioengineering Approaches for Placental Research
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Advanced MRI analysis to detect white matter brain injury in growth restricted newborn lambs
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A nationwide study of maternal exposure to ambient ozone and term birth weight in the United States
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Early Fetal Growth Restriction with or Without Hypertensive Disorders: a Clinical Overview
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Sex-specific placental gene expression signatures of small for gestational age at birth
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Self-citationRheumatic heart disease in pregnancy and neonatal outcomes: A systematic review and meta-analysis
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Self-citationRadiological Modalities for the Assessment of Fetal Growth Restriction: A Comprehensive Review
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Self-citationon behalf of the Canadian Neonatal Network Investigators, Elsayed, E. O. S., Daspal, S., Yee, W. H., Pelausa, E., Canning, R., Shah, P. S., & Yusuf, K. (2019) · Pediatric Research · doi:10.1038/s41390-019-0416-6 · Cited by 20 · see citing works
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Prenatal interventions for fetal growth restriction in animal models: A systematic review
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Maternal–Foetal Effects of Exposure to Bisphenol A: Outcomes and Long-Term Consequences
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Maternal sildenafil impairs the cardiovascular adaptations to chronic hypoxaemia in fetal sheep
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Transient systemic inflammation in adult male mice results in underweight progeny
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Fetal brain development in fetal growth restriction using MRI: a systematic review
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Does fetal growth restriction induce neuropathology within the developing brainstem?
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- Authors
- Malhotra, A., Allison, B. J., Castillo-Melendez, M., Jenkin, G., Polglase, G. R., & Miller, S. L.
- Affiliations
- Hudson Institute of Medical Research (AU)
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2019-02-07
- Volume
- 10
- Pages
- 55-55
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC6374308
- OpenAlex
- W2913735792
- Cited by
- 453
- References
- 203
- Citations by year
- 2026: 53 · 2025: 62 · 2024: 68 · 2023: 77 · 2022: 67 · 2021: 63 · 2020: 52 · 2019: 11
- FWCI
- 7.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Heart Foundation of Australia
- State Government of Victoria
- Cerebral Palsy Alliance
- Medical Research Council
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Keywords
- fetal growth restriction, neonatal morbidity, placental insufficiency, fetal hypoxia, organogenesis, perinatal mortality, long-term outcomes, targeted therapy, neonatal diagnosis
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