by Michelle Reti
Every year in Australia, more than 18,000 babies are born weighing less than 2.5kg. Of these, nearly 4,500 are also born with growth restrictions. A new study made by the University of Sydney is helping doctors and scientists to understand how and why these conditions occur, and what can be done to reduce this high number of cases in the near future.
Intra-Uterine Growth Restriction (IUGR) is second only to prematurity as the greatest cause of illness and death of babies in Australia. It refers to growth and weight restrictions of neonatal babies and before now, it has been an area of study where very little progress has been made. Scientists believe that a lack of protein and sufficient nourishment being carried from the mother through the placenta to feed the baby may be the cause, and the condition could also be linked to the age of the mother.
Scientists at the Kolling Institute of Medical Research at Royal North Shore Hospital are examining the causes of these growth impairments of foetuses in the womb. They hope to gain a better understanding of these pregnancy complications and then develop treatments for these conditions.Supported by a grant from the National Health and Medical Research Council, their work aims to reduce the high number of IUGR babies born each year in Australia. It will also assist scientists and doctors in better understanding how the female body functions during pregnancy.
“Hopefully the evidence can provide some answers and perhaps we will be able to prevent both the short and long term effects that babies and mothers suffer from during Intra-Uterine Growth Restriction,” says Allison Cummins, Lecturer in Midwifery at the University of Technology, Sydney.
Dr Sharon McCracken, Senior Post Doctoral Research Fellow at the Kolling Institute, says cases of IUGR in newborn babies may also increase the risk of developing adult diseases later in life, such as Type 2 diabetes as well as obesity.
“We are working towards a new therapy for the prevention of impaired foetal growth,” Dr McCracken says. “The development of new interventions can only result from new understanding. The results will offer hope for all babies so that they may have a healthy start to life.”
Babies with IUGR are also unable to cope with labour contractions, which can lead to reduced oxygen supply for short periods of time. In cases like these, caesarean deliveries are the safest method of birth. However, this puts heavy pressure on the mental state of the mother and can cause further physical difficulties in having any children in the future. Often there are many issues with screening tests and it is very common for babies to be delivered early via caesarean, only to find that the baby is healthy and there was no IUGR complication at all, says Maralyn Foureur, Professor of Midwifery at the University of Technology.
“The mother’s health will be compromised by a major abdominal operation and that has potentially serious consequences for her recovery and subsequent pregnancies,” Professor Foureur says.
According to Allison Cummins, IUGR can be psychologically devastating for mothers as they try to understand the reasons that their baby is not growing well in utero. “These babies are usually born early and often by caesarean section as labour is seen as too stressful to the already compromised baby. Parents are often unprepared for the early birth,” she says.
The results of the study currently being carried out at the Institute may also help to improve pregnancy screening tests for IUGR in unborn babies to reduce the possibility of inducing an early birth. Screening tests for mothers during pregnancy is very important and is the main focus of antenatal care, with IUGR affecting around six per cent of all pregnancies in Australia.
“We need to get it right if we are recommending early birth of the baby. We need our tests to determine foetal wellbeing to be very accurate because they currently are not as good as we need. More research in this area is very much needed,” Professor Foureur says.