Neonatal Nurse Practitioner Practice Exam

Which factor is associated with symmetrical intrauterine growth restriction?

1. Congenital malformation

2. Maternal malnutrition

3. Uteroplacental insufficiency

4. Infection

The correct answer is: Congenital malformation

Symmetrical intrauterine growth restriction (IUGR) typically occurs when the fetus is uniformly smaller than expected for gestational age. One of the major factors associated with symmetrical IUGR is maternal malnutrition. This condition affects the overall growth and development of the fetus equally, leading to a decrease in both size and weight in a manner that is proportionate. In contrast, congenital malformations often result in disproportionate growth or abnormal development of specific body parts rather than uniformly small size across the entire body. Uteroplacental insufficiency frequently leads to asymmetrical IUGR, where the head may be spared while the body grows smaller due to unequal nutrient and oxygen supply. Infections can also affect fetal growth, but similarly, they might result in complications that do not lead to symmetric growth restriction. By understanding that maternal malnutrition impacts the fetus's nutritional status across all systems, leading to uniform growth limitation, it is clear why this factor stands out as associated with symmetrical IUGR.