Clinical and pathogenetic mechanisms of formation of fetal growth retardation

Abstract

Fetal growth retardation (FGR) is a major cause of child morbidity and mortality, and is also an important medical and social problem due to a wide range of pregnancy complications and negative outcomes in the postnatal period. The results of recent studies indicate that chronic arterial hypertension causes a number of pathological changes in a pregnant woman’s organism, in particular, it increases the risk of FGR.The wide knowledge about the pathogenesis of placental dysfunction and FGR allow to establish that the development of these pathologies is primarily caused by the changes in uterine and placental blood circulation, which leads to metabolic disorders. The important etiological reasons for FGR also include social and biological factors, the influence of narcotic substances, insufficient nutrition, alcohol abuse, tobacco smoking, as well as the use of coumarin or derivatives. The mother’s older age is also a risk factor for the FGR development.Over the past decades, both clinical and experimental studies have established that FGR, caused by the influence of the unfavorable environment of the uterus, is a risk factor for the development of hypertension, as well as various diseases in adults. There are a lot of evidences that support the association of FGR with an increased risk of hypertension in adults, but the mechanisms underlying these processes remain unclear. Both clinical and basic scientific studies have confirmed the theory of intrauterine programming of arterial hypertension in adults. That is why many countries have developed programs for the prevention of FGR. Scientific researches indicate a close relationship between social adaptation and the birth of children with low body weight.The absence of indices decrease in perinatal morbidity and mortality by FGR shows the difficulties caused by polyetiological factors and certain pathogenetic mechanisms of the mentioned complication. Today, the search for an effective pathogenetically based therapy of this pathology continues, which indicates the need for further researches, and the development and implementation of approaches to the prevention of FGR will improve the perinatal putcomes.