Nutritional Problems and Catch-Up Growth in Infants with Intrauterine Growth Retardation

In the past, it was common practice to relate low birthweight to prematurity. However, a number of environmental, maternal, placental, and fetal factors have been recognized as causing intrauterine growth retardation (IUGR) in babies who are small-for-gestational-age (SGA). In the more affluent societies, one-third of the low birthweight babies are SGA. Yet in communities where protein-energy malnutrition and common infections are predominant environmental factors, the incidence of growth retardation due to intrauterine malnutrition can increase to 80% in low birthweight infants (1). The infant who has suffered from intrauterine malnutrition early in the third trimester of pregnancy is potentially at risk of continued growth retardation (2-4) as well as of learning and behavioral problems (5—7). Therefore, perinatal problems must be focused on the prevention of intrauterine growth retardation (1). In the presence of a newborn baby with intrauterine growth retardation, one of the challenging therapeutic problems is to decide when, what, and how to feed this low birthweight infant. In this chapter we shall be concerned with some physiological adaptations and metabolic consequences which modulate such decisions.