Intrauterine Growth Retardation (Failure to Grow Normally Before Birth)

What Is Intrauterine Growth Retardation?

[dropcap]I[/dropcap]ntrauterine growth retardation (IUGR) is a fetal development abnormality characterized by failure to grow normally for gestational period. Specifically, it means the developing baby weighs less than 90% of other babies at the same age.

Intrauterine growth retardation puts the baby at increased risk for complications such as premature birth or that the baby will die inside the womb before birth.¹

Intrauterine growth restriction  may be suspected if the size of the pregnant woman’s uterus is small. The condition is usually confirmed by ultrasound. Further tests may be needed to screen for infection or genetic problems if intrauterine growth retardation is suspected.

Q: Why would a baby not grow normally during pregnancy? A: An unborn baby cannot grow normally  if it does not obtain adequate oxygen and nutrition delivered through the placenta from the mother. Factors that impede adequate delivery of nutrition include:

• Poor placenta placement. Conditions that limit or interfere with space for nutrient and oxygen absorption between the placenta and the uterine wall include 1) low attachment of the placenta near or over the cervix where maternal blood supply is poor, 2) pulling away or bleeding between the placenta and uterine wall, 3) multiple placentas (from multiple babies) sharing the uterine wall may limit blood supply to one or more of the fetuses, and 4) the presence of an hydatid mole,  (non-fertilized egg growing wildly), tumor or fibroids taking up space or growing under or into the placenta. 
• Chromosomal abnormalities in the fetus. Conditions such as trisomy 22  have early onset  of  intrauterine growth retardation  in pregnancy. 
• Poor health of the mother. These factors include 1) anemia which impairs the ability of the mother’s blood to deliver adequate oxygen, 2) preeclampsia which interferes with placenta function, 3) diabetes which impairs proper supply of energy, 4) kidney disease, 5) poor diet, 6) malabsorption, 7) high blood pressure or heart disease, 8) clotting disorders, and 9) toxins and infections during pregnancy that may harm the developing baby such as rubella, cytomegalovirus, toxoplasmosis, and syphilis. 
• Risk factors in the mother. Any of the following may contribute to intrauterine growth retardation:¹

• Alcohol abuse.
• Drug addiction.
• Smoking.

What Is Intrauterine Growth Retardation In Celiac Disease and/or Gluten Sensitivity?

• Intrauterine growth retardation during pregnancy is a reproductive disorder associated with celiac disease and may be an uncommon presenting feature of untreated celiac disease in the mother.

• Although the acute presentation of celiac disease in pregnancy is concerning, potentially of more concern is the risk of intrauterine growth retardation of undiagnosed celiac disease.²

• Zinc deficiency has been incriminated in fetal intrauterine growth retardation.³

How Prevalent Is Intrauterine Growth Retardation In Celiac Disease and/or Gluten Sensitivity?

While women with untreated celiac disease are at higher risk for low birth weight of the newborn,⁴ there is increased risk in progeny of women with untreated celiac disease.²

Comparison of untreated celiac mothers with treated celiac mother indicated that the relative risk of low birth weight baby was 5.84 times higher in untreated mothers.⁵

What Are The Symptoms Of Intrauterine Growth Retardation?

Intrauterine growth retardation is marked by these symptoms:

• A 30% reduction of baby’s birth weight.
• Depending on the cause of intrauterine growth retardation, the developing baby may be symmetrically small, or have a head that is normal size for gestational age, while the remainder of its body is smaller and thinner than expected.¹

How Does Intrauterine Growth Retardation Develop In Celiac Disease and/or Gluten Sensitivity?

• Intrauterine growth retardation results from untreated celiac disease causing nutritional deficiencies in the mother including zinc, iron, omega-6 fatty acid, vitamin A and protein.
• Gluten may exert an autoimmune effect on the placenta.

[box type=”shadow” ]Until birth, the placenta provides the fetus with nutrients and acts as its lungs, kidneys, liver, and endocrine system (hormones), and it is essential for its immune defense. It is the platform for life.⁶

The placenta influences not just the health of a mother and her baby during pregnancy, but also the lifelong health of both.⁷[/box]

Does Intrauterine Growth Retardation Respond To Gluten-Free Diet?

Yes. Gluten free diet is preventive of intrauterine growth retardation and weight of fetus normalizes in response to mother’s gluten free diet.

Study results comparing untreated mothers with celiac disease with treated mothers with celiac disease indicated that the gluten-free diet reduced the relative risk of low birth weight babies from 29.4% down to zero.⁵

6 Steps To Improve Intrauterine Growth Retardation In Celiac Disease and/or Gluten Sensitivity:

• [dropcap]1[/dropcap]Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:

[box type=”shadow” ]Treatment. This condition responds to the complete elimination of gluten, which is the required treatment that improves both intrauterine growth retardation in the developing baby and gut health in the mother.

• Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.
• A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.
• Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.

Correct Your Individual Nutritional Needs.

• Eat foods that can replenish missing nutrients. Find them under NUTRIENT DEFICIENCIES.
• Take nutritional supplements as needed. Find them under NUTRIENT DEFICIENCIES.

Recovery. You should begin to feel better within a week and notice more energy as inflammation subsides and the  absorbing cells that make up the surface lining of your small intestine are better able to function.

• Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.
• Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.⁸
• The intestinal lining may take up to a year to heal.[/box]

• [dropcap]2[/dropcap] Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).

[box type=”shadow” ]Here Are Major Inflammatory Food Types That Reduce Healing:

• Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.⁹
• Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
• Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.⁹
• Fats. Limit deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.⁹.
• Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.⁹
• Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
• Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.⁹
• Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.⁹[/box]

[box type=”shadow” ]Here Are Important Anti-Inflammatory Food Types to Promote Health:

• Fruits. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.
• Non-Starchy Vegetables. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes green leafy vegetables such as lettuce and kale, also onion, broccoli, garlic, and others.
• High Quality Complex Carbohydrates. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
• Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.
• Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.
• Probiotics. Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.
• Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
• Protective Herbs and Spices.  See below #6 below for examples.[/box]

• [dropcap]3[/dropcap] Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

• [dropcap]4[/dropcap] Manage Your Medications Safely:

[box type=”shadow” ]

Certain medications cause deficiencies of  zinc, iron, omega-6 fatty acid, vitamin A and protein in a pregnant woman that can cause intrauterine growth retardation in her developing fetus.  Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS

• Pepcid®, Tagamet®, Zantac® deplete Iron, Vitamin A, Zinc.
• Magnesium and Aluminum Antacid preparations (Gaviscon®, Maalox®, Mylanta®) deplete Iron, Vitamin A, Zinc.
• Alka Seltzer®, Baking Soda deplete Proteins.

ANTIBIOTICS disrupt intestinal permeability which complicates celiac disease.

•  Tetracyclines deplete Iron, Zinc.
• Cipro depletes Zinc.

ANTI-INFLAMMATORIES disrupt intestinal permeability which complicates celiac disease.

• Corticosteroids (Prednisone, Medrol®, Aristocort®, Decadron) deplete Zinc.
• Aspirin and Salicylates deplete Iron.

ANTICONVULSANTS

• Phenobarbital and Barbituates; and Dilantin®, Tegretol®, Mysoline®, Depakane/Depacon® deplete Zinc.

ANTIVIRAL AGENTS

• Zidovudine (Retrovir®, AZT and other related drugs) deplete Zinc.. 

CARDIOVASCULAR DRUGS

• Antihypertensives (Catapres®, Aldomet) deplete Zinc.
• ACE Inhibitors (Capoten®, Vasotec®, Monopril® and others) deplete Zinc..

CHOLESTEROL DRUGS

• Colestid® and Questran® deplete Vitamin A, Iron.

DIURETICS

• Thiazide Diuretics (Hydrochlorothiazide, Enduron®, Diuril®, Lozol®, Zaroxolyn®, Hygroton® and others) deplete  Zinc.
• Loop Diuretics (Lasix®, Bumex®, Edecrin®) deplete Zinc.
• Potassium Sparing Diuretics (Midamor®, Aldactone®, Dyrenium® and others) deplete Zinc.

FEMALE HORMONES disrupt intestinal permeability which complicate celiac disease.

• Oral Contraceptives (Norinyl®, Ortho-Novum®, Triphasil®, and others) deplete Vitamin B2, Vitamin B3, Vitamin B6, Vitamin B12, Vitamin C, Folic Acid, Magnesium, Selenium, Zinc.
• Oral Estrogen/Hormone Replacement (Evista®, Prempro®, Premarin®, Estratab® and others) deplete Vitamin B2, Vitamin B6, Vitamin B12, Vitamin C, Folic Acid, Magnesium, Zinc. [/box]

• [dropcap]5[/dropcap]Nutritional Supplements To Help Correct Deficiencies:

[box type=”shadow” ]

The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.

• 100% prenatal multivitamin/mineral combination once a day is useful to improve overall nutrient levels or as prescribed. This is a safe dose, but always check with your doctor to avoid interactions with medications.
• Ferrous fumarate or gluconate as prescribed following blood test for status.
• Vitamin A as prescribed following blood test for status.
• Chelated zinc as prescribed but do not take at same time as calcium because they compete for absorption.

Storage Note: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet – not in the bathroom or on the kitchen table.[/box]

• [dropcap]6[/dropcap]Manage Natural Remedies: 

[box type=”shadow” ]Hydration:

• Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
• If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
• Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
• What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.[/box]

[box type=”shadow” ]Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

• Raspberry.
• Carrot is also a cleansing digestive tonic.
• Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
• Redbeets also stimulate and improve digestion and are easily digested.
• Cabbage also stimulates and improves digestion and is also a liver decongestant.
• Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
• Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

• Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
• Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
• Parsley also relieves indigestion.
• Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.
• Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

• Cloves are also antispasmodic.
• Nutmeg is also useful for indigestion.
• Ginger.[/box]

[box type=”shadow” ]Exercise Helps:

Exercise improves circulation and rids the body of toxins.

• Walking is aerobic exercise that reconditions the whole body to improve stamina. Read more about Exercise and Fitness.
• Weight training builds muscle. Read more about Exercise and Fitness.
• Stretching improves flexibilty. Read more about Exercise and Fitness.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. [/box]

What Do Medical Research Studies Tell About Intrauterine Growth Retardation In Celiac Disease and/or Gluten Sensitivity?

“Celiac disease and pregnancy outcome.” This study designed as a case-control study and a before-after study investigated the effect of gluten-free diet on pregnancy outcome and lactation in 125 women affected with celiac disease. It found the high incidence of abortion, of low birth weight babies, and of short breast-feeding periods is effectively corrected by gluten-free diet in women with celiac disease.

In the case-control study, comparison of 94 untreated with 31 treated celiac women indicated that the relative risk of abortion was 8.90 times higher the relative risk of low birth weight baby was 5.84 times higher, and duration of breast feeding was 2.54 times shorter in untreated mothers. Abortion, low birth weight of baby, and duration of breast feeding did not significantly relate to the severity of celiac disease among untreated women. In the before-after study, 12 pregnant celiac women in either treated or untreated condition were compared. Results indicated that the gluten-free diet reduced the relative risk of abortion by 9.18 times reduced the number of low birth weight babies from 29.4% down to zero, and increased duration of breast feeding 2.38 times.⁵

Sources:

1. http://www.nlm.nih.gov/medlineplus/ency/article/001500.htm [↩] [↩] [↩]
2. Bajor J, Lomb Z, Anga B, Bero T. Manifestation of adult celiac disease during the puerperium. Orvosi Hetilap. Dec 28, 2003;144(52):2565-9. [↩] [↩]
3. Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Annals of the New York Academy of Sciences. Mar 15, 1993;678:178-92. [↩]
4. Stazi AV, Mantovani A. A risk factor for female fertility and pregnancy: celiac disease. Gynecologica endocrinology: the Official Journal of the International Society of Gynecological Endocrinology. Dec 2000;14(6):454-63. [↩]
5. Ciacci C, Cirillo M, Auriemma G, Di Dato G, Sabbatini F, Mazzacca G. Celiac disease and pregnancy outcome. Am J Gastroenterol. 1996 Apr;91(4):718-22. [↩] [↩] [↩]
6. NIH MedlinePlus. The Mystery and Miracle of the placenta. Fall 1916. P21. [↩]
7. Spong Catherine, MD, acting director of NICHD. NIH MedlinePlus. The Mystery and Miracle of the placenta. Fall 1916. P21. [↩]
8. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
9. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩] [↩]