Table 1: Risk factors in IUGR.

OriginRisk factors

Maternal causes

 Medical conditions

  (i) Vascular diseases Chronic hypertension
Preeclampsia early in gestation
Diabetes mellitus
Systemic lupus erythematosus
Chronic kidney disease
Inflammatory bowel disease
Severe lung disease
  (ii) Infections Syphilis
Toxoplasmosis
Cytomegalovirus
Rubella virus
Hepatitis B virus
Herpes simplex virus 1 or 2
HIV-1
Helicobacter pylori
Malaria

 Social conditions

   (i) Malnutrition Low prepregnancy weight and small maternal size
Poor weight gain during pregnancy, especially in latter half
Nutritional deficiencies: protein folic acid, vitamin A, B, C, zinc, calcium
   (ii) Drugs use Cigarettes, alcohol, heroin, cocaine
Teratogens, antimetabolites, and therapeutic agents such as trimethadione, warfarin, and phenytoin
   (iii) HistoryRecent pregnancy and/or high parity
Multiple pregnancy
Prior history of IUGR pregnancy
Residing at altitude over 5,000 ft (1,500 m)

Fetal Causes

 Genetic factorsRace, ethnicity, nationality, sex parity (primiparous, weigh less than subsequent siblings), genetic disorders (Achondroplasia, Russell-Silver syndrome)
 Chromosomal anomalies Chromosomal deletions
Trisomy 13,18, and 21
 Congenital malformations Anencephaly, GI atresia, Potter’s syndrome, and pancreatic agenesis

Placental Causes

 Placental insufficiencyReduced blood flow
 Anatomic problems Multiple infarcts
Aberrant cord insertions
Umbilical vascular thrombosis and hemangiomas
Premature placental separation
Small Placenta