The Association Between Maternal Nutritional Status and Intrauterine Growth Restriction: A Literature Review

Authors

  • Nurul Azizah Medical Education Program, Faculty of Medicine, Universitas Muslim Indonesia, Makassar, Indonesia Author
  • M Hamsah Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Muslim Indonesia, Makassar, Indonesia Author
  • Nugraha Utama Pelupessy Department of Obstetrics and Gynaecology, Ibnu Sina Hospital, Makassar, Indonesia Author

DOI:

https://doi.org/10.65280/panhsj.v2i1.49

Keywords:

maternal nutritional status, intrauterine growth restriction, pregnancy, placental insufficiency

Abstract

Background: Intrauterine Growth Restriction (IUGR) is a pathological condition in which the fetus fails to achieve its genetically determined growth potential and remains a major contributor to perinatal morbidity and mortality. Maternal nutritional status is a key modifiable factor influencing placental function and fetal growth.

Aim: This study aimed to analyse the association between maternal nutritional status and the occurrence of intrauterine growth restriction.

Methods: This study employed a descriptive-analytic literature review approach. Scientific articles published within the last ten years were reviewed. Maternal nutritional indicators analysed included pre-pregnancy body mass index (BMI), mid-upper arm circumference (MUAC), gestational weight gain, haemoglobin levels, and macro- and micronutrient intake.

Results: Poor maternal nutritional status, including low BMI, MUAC <23.5 cm, inadequate gestational weight gain, anaemia, and micronutrient deficiencies, was consistently associated with an increased risk of IUGR. These conditions were linked to placental insufficiency, reduced uteroplacental perfusion, and chronic fetal hypoxia.

Conclusion: Maternal nutritional status is significantly associated with intrauterine growth restriction. Optimising maternal nutrition before and during pregnancy is essential to prevent IUGR and improve perinatal outcomes.

References

[1] J. Wang, C. Feng, T. Liu, M. Shi, G. Wu, and F. W. Bazer, ‘Physiological alterations associated with intrauterine growth restriction in fetal pigs: Causes and insights for nutritional optimization’, Sep. 01, 2017, John Wiley and Sons Inc. doi: 10.1002/mrd.22842. DOI: https://doi.org/10.1002/mrd.22842

[2] G. G. Woldeamanuel, T. G. Geta, T. P. Mohammed, M. B. Shuba, and T. A. Bafa, ‘Effect of nutritional status of pregnant women on birth weight of newborns at Butajira Referral Hospital, Butajira, Ethiopia’, SAGE Open Med., vol. 7, Jan. 2019, doi: 10.1177/2050312119827096. DOI: https://doi.org/10.1177/2050312119827096

[3] M. K. Kabahenda and B. J. Stoecker, ‘Associations between maternal dietary intake and nutritional status with fetal growth at 14 to 26 weeks gestation: a cross- sectional study’, BMC Nutr., vol. 10, no. 1, Dec. 2024, doi: 10.1186/s40795-024-00885-3. DOI: https://doi.org/10.1186/s40795-024-00885-3

[4] H. D. Kamphof, S. Posthuma, S. J. Gordijn, and W. Ganzevoort, ‘Fetal Growth Restriction: Mechanisms, Epidemiology, and Management’, Jul. 22, 2022, Wolters Kluwer Health. doi: 10.1097/FM9.0000000000000161. DOI: https://doi.org/10.1097/FM9.0000000000000161

[5] A. Apostolopoulou, A. Tranidou, I. Tsakiridis, E. Magriplis, T. Dagklis, and M. Chourdakis, ‘Effects of Nutrition on Maternal Health, Fetal Development, and Perinatal Outcomes’, Feb. 01, 2024, Multidisciplinary Digital Publishing Institute (MDPI). doi: 10.3390/nu16030375. DOI: https://doi.org/10.3390/nu16030375

[6] N. K. Pane, U. H. Almadany, and E. Sujoko, ‘Status Gizi Ibu Hamil sebagai Prediktor Kejadian Stunting pada Anak Usia 24–59 Bulan di Kecamatan Padangsidimpuan Selatan’, PubHealth Jurnal Kesehatan Masyarakat, vol. 4, no. 1, pp. 46–53, Jul. 2025, doi: 10.56211/pubhealth.v4i1.1026. DOI: https://doi.org/10.56211/pubhealth.v4i1.1026

[7] T. Margareta Kurniawan, P. Anggraini, M. Audila Anggraini, and P. Studi Pendidikan Dokter, ‘Diagnosis and Management of Fetal Growth Restriction’, 2023, doi: 10.29303/jbt.v23i4.5547. DOI: https://doi.org/10.29303/jbt.v23i4.5447

[8] J. Yang, Q. Chang, Q. Du, X. Liu, S. Dang, and X. Tian, ‘Maternal iron nutrition during pregnancy and fetal intrauterine growth’, Nutr. J., vol. 23, no. 1, Dec. 2024, doi: 10.1186/s12937-024-01042-z. DOI: https://doi.org/10.1186/s12937-024-01042-z

[9] S. D. Murki S, ‘Intrauterine Growth Retardation - A Review Article. J Neonatal Biol. 2014;3(3):1-11.’, J Neonatal Biol., vol. 3, no. 3, pp. 1–11, 2014.

[10] P. Tsikouras et al., ‘Diagnosis, Prevention, and Management of Fetal Growth Restriction (FGR)’, Jul. 01, 2024, Multidisciplinary Digital Publishing Institute (MDPI). doi: 10.3390/jpm14070698. DOI: https://doi.org/10.3390/jpm14070698

[11] A. A. Baschat et al., ‘The role of the fetal biophysical profile in the management of fetal growth restriction’, Apr. 01, 2022, Elsevier Inc. doi: 10.1016/j.ajog.2022.01.020. DOI: https://doi.org/10.1016/j.ajog.2022.01.020

[12] S. S. S. P. Sharma D, ‘Intrauterine Growth Retardation: Antenatal and Postnatal Aspects.’, Clin. Med. Insights Pediatr., no. 10, p. 67, 2016. DOI: https://doi.org/10.4137/CMPed.S40070

[13] T. Durá-Travé and F. Gallinas-Victoriano, ‘Vitamin D and Intrauterine Growth Restriction (IUGR)’, Dec. 01, 2025, Multidisciplinary Digital Publishing Institute (MDPI). doi: 10.3390/ijms262311422. DOI: https://doi.org/10.20944/preprints202509.2217.v1

[14] F. Arnan, M. T. Chalid, M. F. Farid, E. Lukas, and E. Wewengkang, ‘Vitamin D and intrauterine growth restriction: A cross-sectional study’, Italian Journal of Medicine, vol. 18, no. 4, 2024, doi: 10.4081/itjm.2024.1833. DOI: https://doi.org/10.4081/itjm.2024.1833

[15] P. Firsty, P. Putri, M. A. Bachnas, N. Widya, P. Anggraini, and A. Laqif, ‘Perbandingan Faktor Risiko antara Pertumbuhan Janin Terhambat Onset Dini dan Lambat di RSUD Dr. Moewardi’.

[16] A. Malhotra, B. J. Allison, M. Castillo-Melendez, G. Jenkin, G. R. Polglase, and S. L. Miller, ‘Neonatal morbidities of fetal growth restriction: Pathophysiology and impact’, 2019, Frontiers Media S.A. doi: 10.3389/fendo.2019.00055. DOI: https://doi.org/10.3389/fendo.2019.00055

[17] N. T. Tran, L. T. Nguyen, Y. Berde, Y. L. Low, S. L. Tey, and D. T. T. Huynh, ‘Maternal nutritional adequacy and gestational weight gain and their associations with birth outcomes among Vietnamese women’, BMC Pregnancy Childbirth, vol. 19, no. 1, Dec. 2019, doi: 10.1186/s12884-019-2643-6. DOI: https://doi.org/10.1186/s12884-019-2643-6

[18] F. Gaccioli, I. L. M. H. Aye, U. Sovio, D. S. Charnock-Jones, and G. C. S. Smith, ‘Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers’, Feb. 01, 2018, Mosby Inc. doi: 10.1016/j.ajog.2017.12.002. DOI: https://doi.org/10.1016/j.ajog.2017.12.002

[19] Ş. Pala, R. Atilgan, and N. İlhan, ‘High amniotic fluid fractalkine and MIP-1β levels are associated with intrauterine growth restriction: a prospective cohort study’, Turk. J. Med. Sci., vol. 54, no. 1, pp. 280–290, 2024, doi: 10.55730/1300-0144.5789. DOI: https://doi.org/10.55730/1300-0144.5789

[20] N. Machairiotis, V. Pergialiotis, K. Vlassis, T. Troupis, and N. Vrachnis, ‘Association of amniotic fluid Neurotrophins levels with intrauterine growth restriction’, 2023, Hellenics Society of Obstetrics and Gynecology. doi: 10.33574/hjog.0525. DOI: https://doi.org/10.33574/hjog.0525

[21] C. Magudapathi, S. Thirunavukkarasu, and S. Ravikumar, ‘Umbilical Artery Doppler Flow Velocimetry in Intrauterine Growth Restriction and its Relation to Perinatal Outcome’, International Journal of Infertility and Fetal Medicine, vol. 13, no. 3, pp. 87–90, Sep. 2022, doi: 10.5005/jp-journals-10016-1297. DOI: https://doi.org/10.5005/jp-journals-10016-1297

[22] B. Cancarevic Djajic et al., ‘Predictive Value of Venous Ductus Doppler in Perinatal Outcomes in Fetal Growth Restriction’, Cureus, Sep. 2025, doi: 10.7759/cureus.92838. DOI: https://doi.org/10.7759/cureus.92838

[23] M. E. Street and S. Bernasconi, ‘Endocrine-disrupting chemicals in human fetal growth’, Feb. 01, 2020, MDPI AG. doi: 10.3390/ijms21041430. DOI: https://doi.org/10.37247/PAMB.1.2020.42

[24] P. Jha et al., ‘Assessment of Amniotic Fluid Volume in Pregnancy’, Radiographics, vol. 43, no. 6, Jun. 2023, doi: 10.1148/rg.220146. DOI: https://doi.org/10.1148/rg.220146

[25] G. Rizzo et al., ‘Role of Doppler ultrasound at time of diagnosis of late-onset fetal growth restriction in predicting adverse perinatal outcome: prospective cohort study’, Ultrasound in Obstetrics and Gynecology, vol. 55, no. 6, pp. 793–798, Jun. 2020, doi: 10.1002/uog.20406. DOI: https://doi.org/10.1002/uog.20406

Downloads

Published

31.01.2025

Issue

Section

Articles

How to Cite

Azizah, N., Hamsah, M., & Pelupessy, N. U. . (2025). The Association Between Maternal Nutritional Status and Intrauterine Growth Restriction: A Literature Review. Physical Activity, Nutrition and Health Sciences Journal, 1(2), 11-19. https://doi.org/10.65280/panhsj.v2i1.49