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close this bookCauses and Consequences of Intrauterine Growth Retardation, Proceedings of an IDECG workshop, November 1996, Baton Rouge, USA, Supplement of the European Journal of Clinical Nutrition (International Dietary Energy Consultative Group - IDECG, 1996, 100 pages)
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close this folderCurrent growth standards, definitions, diagnosis and classification of fetal growth retardation
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close this folderLevels and patterns of intrauterine growth retardation in developing countries
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close this folderBirth weights and stillbirths in historical perspective
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close this folderBiological mechanisms of environmentally induced causes of IUGR
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close this folderSocioeconomic determinants of intrauterine growth retardation
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View the documentSocioeconomic disparities in IUGR: Mediating factors
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close this folderEffects of intrauterine growth retardation on mortality morbidity in infants and young children
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close this folderIntrauterine growth retardation, body size, body composition and physical performance in adolescence
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close this folderNeurodevelopmental outcome of small-for-gestational-age infants
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close this folderSmall for gestational age, term babies, in the first six years of life
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close this folderEffects of intrauterine growth retardation on mental performance and behavior, outcomes during adolescence and adulthood
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View the documentSchool age outcomes of young adolescents with intrauterine growth failure (Table 1)
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close this folderFetal growth and adult disease
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close this folderNutritional interventions to prevent intrauterine growth retardation: Evidence from randomized controlled trials
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close this folderReport of the IDECG group on definitions, classifications, causes, mechanisms and prevention of IUGR
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close this folderReport of the IDECG group on effects of IUGR on infants, children and adolescents: Immunocompetence, mortality, morbidity, body size, body composition, and physical performance
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close this folderReport of the IDECG/IUNS working group on IUGR effects on neurological, sensory, cognitive, and behavioral function
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close this folderReport of the IDECG group on variation in fetal growth and adult disease
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Secular trends in IUGR and its determinants

Both Canada and the United States have witnessed a modest decline in the incidence of low birth weight over the last two decades. Most or all of this decline is due to a lower incidence of IUGR, rather than of preterm birth (Ng and Wilkins, 1994; Kessel et al, 1984; Division of Nutrition, National Center for Chronic Disease Prevention and Health Promotion, 1994). In Canada, the birth weight of term infants increased approximately 130-140 grams between 1972 and 1986, with no apparent change in the gestational age distribution or in the growth in infants delivered preterm (Arbuckle and Sherman, 1989). Thus in both the United States and Canada, the only important change in fetal growth over the last several decades has been an increase in the size of term infants.

Based on simultaneous trends in etiologic determinants, this increase in the size of term births appears to reflect three primary factors: (1) a secular trend toward increasing prepregnancy body mass index (Flegal et al, 1988), reflecting a general trend toward increasing adiposity (which has been particularly evident in North America, but observed in most western countries); (2) a marked secular trend toward higher gestational weight gains, which have increased from 9 or 10 kilograms in the 1950's and 60's to 15 kilograms, on average, in recent years (Taffel; Eastman and Jackson, 1968; Niswander and Jackson, 1974; Keppel and Taffel, 1993); and (3) substantial decreases in cigarette smoking among pregnant women (Kleinman and Kopstein, 1987), presumably in response to increasing knowledge and publicity about the adverse effects of smoking on health, in general, and on pregnancy outcome, in particular.