The Two Faces of IUGR: Deciphering the Spectrum of Symmetrical and Asymmetrical IUGR and Mapping Incidence of Causal Dynamics and their Echo on Tracing the Roots of Growth

Abstract

Background: Intrauterine growth restriction (IUGR) is a major cause of perinatal morbidity and mortality, particularly in developing countries. It results from a complex interplay of maternal, fetal, placental, and environmental factors. Clinically, IUGR is classified as symmetrical or asymmetrical, each with distinct etiopathological mechanisms and perinatal implications. This study aimed to determine the incidence and causal factors of symmetrical and asymmetrical IUGR and to correlate these with fetal and perinatal outcomes.
Methods: This cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology, C.R. Gardi Hospital, Ujjain, from 2023 to 2025. A total of 335 pregnant women diagnosed with IUGR were evaluated, 208 asymmetrical and 127 symmetrical. Detailed maternal history, clinical assessment, ultrasonography and Doppler studies were performed. Data were analyzed during SPSS version 25.0, with p < 0.05 considered statistically significant.
Results: Asymmetrical IUGR was more prevalent (62.1%) than symmetrical (37.9%). The majority of cases occurred in women aged 21–30 years. Symmetrical IUGR was more associated with early-onset maternal conditions such as hypertension (28.3%), anemia (30.7%), and nutritional deficiencies (24.4%), while asymmetrical IUGR correlated more with diabetes mellitus (18.8%). Fetal Doppler and biometric parameters showed no statistically significant differences between groups. Neonatal outcomes were comparable, with survival rates exceeding 95% in both subtypes.
Conclusion: Both types of IUGR present distinct etiological patterns but similar perinatal outcomes. Early detection, targeted antenatal surveillance, and individualized management are essential to optimize fetal growth and improve neonatal prognosis.