One of the most common causes of asymmetric growth restriction is which of the following?

• A. Chromosomal abnormalities
• B. Severe, poorly controlled maternal hypertension
• C. Uteroplacental insufficiency
• D. Intrauterine infections

Answer: (C)

Asymmetric growth restriction arises when the placenta cannot deliver enough oxygen and nutrients to the fetus in the latter part of pregnancy. This placental insufficiency leads to a “head-sparing” pattern: the abdomen and body growth slow while the head circumference stays relatively preserved. The main mechanism behind this pattern is uteroplacental insufficiency, the reduced placental perfusion that limits fetal growth.

Chromosomal abnormalities and intrauterine infections tend to cause symmetric growth restriction, where the entire fetus is small because the insult affects early development. Severe, poorly controlled maternal hypertension contributes to placental insufficiency and is a risk factor, but the direct cause of the asymmetric pattern is uteroplacental insufficiency.