{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:54:22Z","timestamp":1792061662411,"version":"4.4.0"},"reference-count":117,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["NU 301\/2-1"],"award-info":[{"award-number":["NU 301\/2-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["NU 137\/4-1"],"award-info":[{"award-number":["NU 137\/4-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["AL 1636\/5-1"],"award-info":[{"award-number":["AL 1636\/5-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Intrauterine growth restriction (IUGR) and being small for gestational age (SGA) are two distinct conditions with different implications for short- and long-term child development. SGA is present if the estimated fetal or birth weight is below the tenth percentile. IUGR can be identified by additional abnormalities (pathological Doppler sonography, oligohydramnion, lack of growth in the interval, estimated weight below the third percentile) and can also be present in fetuses and neonates with weights above the tenth percentile. There is a need to differentiate between IUGR and SGA whenever possible, as IUGR in particular is associated with greater perinatal morbidity, prematurity and mortality, as well as an increased risk for diseases in later life. Recognizing fetuses and newborns being \u201cat risk\u201d in order to monitor them accordingly and deliver them in good time, as well as to provide adequate follow up care to ameliorate adverse sequelae is still challenging. This review article discusses approaches to differentiate IUGR from SGA and further increase diagnostic accuracy. Since adverse prenatal influences increase but individually optimized further child development decreases the risk of later diseases, we also discuss the need for interdisciplinary follow-up strategies during childhood. Moreover, we present current concepts of pathophysiology, with a focus on oxidative stress and consecutive inflammatory and metabolic changes as key molecular mechanisms of adverse sequelae, and look at future scientific opportunities and challenges. Most importantly, awareness needs to be raised that pre- and postnatal care of IUGR neonates should be regarded as a continuum.<\/jats:p>","DOI":"10.3390\/cells13060501","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T13:23:11Z","timestamp":1710336191000},"page":"501","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Intrauterine Growth Restriction: Need to Improve Diagnostic Accuracy and Evidence for a Key Role of Oxidative Stress in Neonatal and Long-Term Sequelae"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0674-804X","authenticated-orcid":false,"given":"Eva","family":"N\u00fcsken","sequence":"first","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0315-6513","authenticated-orcid":false,"given":"Sarah","family":"Appel","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9002-1600","authenticated-orcid":false,"given":"Leon","family":"Saschin","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7940-9612","authenticated-orcid":false,"given":"Celien","family":"Kuiper-Makris","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Oberholz","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0108-0738","authenticated-orcid":false,"given":"Charlotte","family":"Sch\u00f6mig","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Tauscher","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"D\u00f6tsch","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Kribs","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3176-0411","authenticated-orcid":false,"given":"Miguel A.","family":"Alejandre Alcazar","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"},{"name":"Institute for Lung Health (ILH), University of Giessen and Marburg Lung Center (UGMLC) and Cardiopulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany"},{"name":"Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931 Cologne, Germany"},{"name":"Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5749-7183","authenticated-orcid":false,"given":"Kai-Dietrich","family":"N\u00fcsken","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Pediatric and Adolescent Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/S0140-6736(86)91340-1","article-title":"Infant Mortality, Childhood Nutrition, and Ischaemic Heart Disease in England and Wales","volume":"327","author":"Barker","year":"1986","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1210\/en.2010-1116","article-title":"Fetal programming of gene expression in growth-restricted rats depends on the cause of low birth weight","volume":"152","author":"Schneider","year":"2011","journal-title":"Endocrinology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/cen.12844","article-title":"Differential effects of low birthweight and intrauterine growth restriction on umbilical cord blood insulin-like growth factor 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