Fetal growth restriction and post natal growth failure : Improving prevention in resource-constrained settings,  a  narrative review.

Sandrine Kengne Kamga; Julienne Louise Ngo Likeng; Anne Esther Njom Nlend

Authors

Sandrine Kengne Kamga Author
Julienne Louise Ngo Likeng Author
Anne Esther Njom Nlend Author

Abstract

Postnatal growth failure (PGF) is a common problem in low birth weight (LBW) children. It is estimated that fetal growth restriction (FGR) can concern less than 10% of pregnancies in high resource settings while almost 25% are affected in low- and middle-income countries (LMICs). In order to reach the target of ending low birth weight by 2025, notably in low resource settings where prevalence is still high, we conducted a narrative review around the main factors affecting PGF. The aim of this study was to describe risk factors of postnatal growth failure after FGR and to extract solutions for the field in our context. We found that prenatal risk factors particularly (factors related to infections, exposure to toxins, chronic diseases of the mother, nutritional deficiencies of the mother) influence the occurrence of postnatal growth failure or its prognosis in newborn. After birth, inappropriate uptake of both energy and protein compromise extrauterine growth. It is therefore essential in LMICs to start this prevention early, through nutrition programmes, fighting against malaria in pregnancy. At birth, nutritional support is a key element for prevention of post-natal growth failure. It should emphasize breastfeeding with own mother milk (OMM) rather than donor bank human milk. In addition, hybrid feeding or fortification of OMM using preterm formula powder might be indicated to ensure appropriate protein and caloric uptake. Basically, putting to scale Kangaroo mother care is a must. At last, routine monitoring of height and head circumference, should be added to weight, as indicator of lean body mass in all neonatal units.

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