Title Novorođenče s intrauterinim zastojem u rastu Title (english) Newborn with intrauterine growth restriction Author Mia Mihaljević Mentor Nada Sindičić Dessardo (mentor)Committee member Ruža Grizelj (predsjednik povjerenstva)Committee member Marija Jelušić (član povjerenstva)Committee member Nada Sindičić Dessardo (član povjerenstva)Granter University of Zagreb Defense date and country 2023-07-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Intrauterini zastoj u rastu ( en gl intrauterine growth restriction jedan je od značajnih uzroka perinatalnog i neonatalnog morbiditeta i mortaliteta. Najveća pojavnost zastoja u rastu bilježi se u zemljama u razvoju zbog socioekonomskih čimbenika koji direktno utječu na prehranu i životne uvjete majki. IUGR se može definirati kao nemogućnost fetusa da ostvari svoj intrinzični potencijal za rast. Kako je intrinzični potencijal za rast nekog djeteta teško procijeniti, u praksi se IUGR najčešće definira tjelesnom masom novorođenog djeteta ispod 10. percentilne krivulje specifične za dob, spol, partitet majke i etničku pripadnost ili dvije standardne devijacije ispod prosječne mase za gestacijsku dob. Fetalni rast i razvoj ovisan je o brojnim čimbenicima koji se mogu podijeliti na genetski potencijal za rast fetusa i potporu fetalnog rasta koju čini uteroplacentalni prijenos hranjivih tvari i kisika. Upravo je gubitak potpore rastu, odnosno nesrazmjer između potreba fetusa i funkcije posteljice najčešća etiologija intrauterinog zastoja u rastu. Osnovna metoda praćenja rasta fetusa in utero je fetalna biometrija. Fetus se na nepovoljne intrauterine uvijete prilagođava promjenama u kardiovaskularnom, metaboličkom i endokrinom sustavu. Rane postnatalne komplika cije IUGR a su perinatalna asfiksija, hipotermija, hipoglikemija, hipokalcemija, policitemija, žutica, poteškoće s hranjenjem i nekrotizirajući enterokolitis. Djeca rođena s IUGR-om češće obolijevaju od kroničnih kardiovaskularnih, metaboličkih, bubrežnih, neuroloških i respiratornih bolesti tijekom života, što se objašnjava Barkerovom teorijom fetalnog programiranja. Prema toj teoriji epigenetske promjene nastale prenatalno čine podlogu za razvoj kroničnih bolesti. Trenutno se istražuje učinkovitost brojnih lijekova i dodataka prehrani u poboljšanju prenatalnog i postnatalnog rasta kod IUGR. Za sada u poboljšanju kliničkih ishoda, u slučajevima visokorizičnih trudnoća, najveću korist ima prenatalna primjena kortikosteroida
Abstract (english) Intrauterine growth restriction ( is a frequent complication of pregnancy and is one of the major causes of perinatal and neonatal mortality and morbidity. The highest incidence of IUGR is recorded in developing countries conditioned by socioeconomic factors that directly affect mother's nutrition and living conditions. IUGR is often defined as the inability of the fetus to reach its intrinsic growth potential. As it is hard to define the intrinsic growth potential of a fetus, in practice, IUGR is most often defined as body weight of a newborn child that is below the 10th percentile of an ethnic and seeks specific birth weight for a specific gestational age, or the birth weight that is less than 2 standard deviations below the mean. Fetal growth and development depend on several factors that can be divided into the genetic potential for fetal growth and the fetal growth support provided by the uteroplacental transfer of nutrients and oxygen. The most common etiology of intrauterine growth restriction is the loss of growth support, which occurs because of the disproportion between the needs of the fetus and the function of the placenta. The loss of placental functions is called placental insufficiency and is most often caused by disturbed placentation. The basic method of monitoring fetal growth in utero is fetal biometry. The fetus adapts to the adverse intrauterine environment with changes in the cardiovascular, metabolic, and endocrine systems. Early postnatal complications of IUGR include hypoglycemia, hypothermia, polycythemia, perinatal asphyxia, necrotizing enterocolitis, and others. Children who survive IUGR have a higher risk of developing cardiovascular, metabolic, renal, neurological, and respiratory diseases in adulthood, which is explained by the Barker's theory of the fetal origin of adult disease. According to this theory, epigenetic changes created prenatally form the basis for the development of chronic diseases. Numerous drugs and nutritional supplements that are currently in clinical trials show potential improvement of prenatal and postnatal growth in IUGR. The greatest benefits in the prevention of growth restriction postnatal complications were shown using corticosteroids in high risk pregnancies.
Keywords
intrauterini zast oj u rastu ( insuficijencija posteljice
novorođenče
fetalno programiranje
Keywords (english)
intrauterine growth restriction (IUGR)
placental insufficiency
newborn
fetal programming
Language croatian URN:NBN urn:nbn:hr:105:870282 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-10-26 11:24:12
