Fetal growth

Effective monitoring of fetal growth is a key aspect of antenatal care. The short-term complications of fetal growth restriction (FGR) include stillbirth, prematurity, perinatal morbidity and decreased fetal reserve during labour. At the other end of the spectrum, macrosomia is associated with birth trauma and neonatal metabolic disturbances. Evidence also exists that these growth disturbances may have long-term complications for several organ systems extending well beyond childhood [1]. Therefore, any advance in the surveillance and prevention of deranged fetal growth is likely to reap large social and economic benefits. The clinical performance of screening methods for FGR remains poor. Screening policies for detecting the small for-gestational age (SGA) baby using clinical methods succeed in only approximately a quarter of cases [2,3]. It has also been questioned whether, with current methods, antenatal detection actually improves outcome [4]. A systematic review of randomized trials suggests that, to date, most prenatal interventions do not show any significant effects on Short-term perinatal outcome [5]. In this article we focus on recent developments in our understanding of fetal growth abnormalities and their clinical detection.