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      Intrauterine Growth Restriction: Definition and Etiology

      Hormone Research in Paediatrics

      S. Karger AG

      Classification, Etiology, Determinants, IUGR, Definition

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          Abstract

          Intrauterine growth restriction (IUGR) is a frequent cause of perinatal morbidity as well as of impaired growth during childhood. Therefore, a clearcut definition of IUGR to identify those babies at risk is essential: The label IUGR generally should be assigned only to those infants with birth weight and/or birth length below the 10th percentile for GA with a pathologic restriction of fetal growth. According to the recent literature, clinical classification of the retarded babies seems to be less significant. Among the etiologic factors responsible for IUGR, one-third of the variations in birth weight are determined by genetic variables, two-thirds by environmental factors. In spite of the fact that a long list of established, different etiologic factors is known, in at least 40% of children no underlying pathology can be identified. Among the preventable, environmental causes of IUGR, smoking of the mother during pregnancy is by far the most important one, which is responsible for more than one third of all IUGR newborns.

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          Association of young maternal age with adverse reproductive outcomes.

          Pregnancy in adolescence is associated with an excess risk of poor outcomes, including low birth weight and prematurity. Whether this association simply reflects the deleterious sociodemographic environment of most pregnant teenagers or whether biologic immaturity is also causally implicated is not known. To determine whether a young age confers an intrinsic risk of adverse outcomes of pregnancy, we performed stratified analyses of 134,088 white girls and women, 13 to 24 years old, in Utah who delivered singleton, first-born children between 1970 and 1990. Relative risk for subgroups of this study population was examined to eliminate the confounding influence of marital status, educational level, and the adequacy of prenatal care. The adjusted relative risk for the entire study group was calculated as the weighted average of the stratum-specific risks. Among white married mothers with educational levels appropriate for their ages who received adequate prenatal care, younger teenage mothers (13 to 17 years of age) had a significantly higher risk (P < 0.001) than mothers who were 20 to 24 years of age of delivering an infant who had low birth weight (relative risk, 1.7; 95 percent confidence interval, 1.5 to 2.0), who was delivered prematurely (relative risk, 1.9; 95 percent confidence interval, 1.7 to 2.1), or who was small for gestational age (relative risk, 1.3; 95 percent confidence interval, 1.2 to 1.4). Older teenage mothers (18 or 19 years of age) also had a significant increase in these risks. Even though sociodemographic variables associated with teenage pregnancy increase the risk of adverse outcomes, the relative risk remained significantly elevated for both younger and older teenage mothers after adjustment for marital status, level of education, and adequacy of prenatal care. In a study of mothers 13 to 24 years old who had the characteristics of most white, middle-class Americans, a younger age conferred an increased risk of adverse pregnancy outcomes that was independent of important confounding sociodemographic factors.
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            Peptide signaling in human placenta and membranes: autocrine, paracrine, and endocrine mechanisms

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              Author and article information

              Journal
              HRE
              Horm Res Paediatr
              10.1159/issn.1663-2818
              Hormone Research in Paediatrics
              S. Karger AG
              978-3-8055-6700-8
              978-3-318-00313-0
              1663-2818
              1663-2826
              1998
              April 1998
              17 November 2004
              : 49
              : Suppl 2
              : 1-6
              Affiliations
              University Children’s Hospital, Growth Research Center, Tübingen, Germany
              Article
              53079 Horm Res 1998;49(suppl 2):1–6
              10.1159/000053079
              9730664
              © 1998 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Figures: 1, Tables: 4, References: 31, Pages: 6
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