Foetal growth restriction (FGR) may affect the growth and development of babies long after birth, affecting their early years in school, a new report has found.
For the first time, a study has tracked the growth of babies diagnosed with the condition from 14 weeks gestation to six years of age.
Researchers from King’s College London and University College London found that differences experienced in utero, such as higher heart rate and lower weight, can persist after birth and cause compounding disadvantages in early childhood, including delays in motor and cognitive development.
FGR happens when a baby does not grow as expected in the womb, often because the placenta is not able to provide enough oxygen and nutrients.
It can mean that an unborn baby with the condition has an estimated size within the smallest 3%.
The new study analysed datasets of participants between 14 weeks of gestation and six years of age, to assess ongoing impacts of FGR on energy, growth and motor and cognitive development.
Growth and motor development
MRI brain scans showed that babies affected by FGR had significantly less white matter. This enables different areas of the brain to communicate with each other.
The findings suggest this is due to the body adapting to reduced energy in the womb by limiting brain development to conserve resources.
The study showed children affected tended to gain weight more slowly and often remained smaller than their peers.
Poorer growth was linked to less optimal motor and cognitive development at the age of one to two years, even after taking FGR diagnosis into account.
Ongoing vulnerability
Dr Kimberley Whitehead, senior lecturer at King’s College London and an author of the study, said: “We analysed motor and cognitive ability at average two years of age in this study. Children affected by foetal growth restriction had scores four to five points lower than other children, especially if this began earlier in the pregnancy.
“Separately, we found that for every week premature these children were, their scores were one point lower, for example, if they were 10 weeks premature their scores were 10 points lower.
“Finally, we found that children who were smaller than expected, even accounting for a foetal growth restriction diagnosis, had further reduced scores.
“This suggests that foetal growth restriction may prevent children from reaching their full potential at school, but especially when in combination with prematurity.
“For health, care and early years education practitioners, this study highlights the importance of seeing FGR as an ongoing developmental vulnerability.
“Careful monitoring and timely support may help children affected reach their potential.”
