Optimal fetal growth: a misconception?

Mark Hanson, Torvid Kiserud, Gerard H A Visser, Peter Brocklehurst, Eric B Schneider

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


Alterations in fetal growth trajectory, either in terms of individual organs or the fetal body, constitute part of a suite of adaptive responses that the fetus can make to a developmental challenge such as inadequate nutrition. Nonetheless, despite substantial changes in nutrition in many countries over recent centuries, mean birthweight has changed relatively little. Low birthweight is recognized as a risk factor for later noncommunicable disease, although the developmental origins of such risk are graded across the full range of fetal growth and birthweight. Many parental and environmental factors, some biological and some cultural, can influence fetal growth, and these should not be viewed as abnormal. We argue that the suggestion of establishing a universal standard for optimal fetal growth ignores the breadth of these normal fetal responses. It may influence practice adversely, through incorrect estimation of gestational age and unnecessary elective deliveries. It raises ethical as well as practical issues.

Original languageEnglish
Pages (from-to)332.e1-332.e4
Number of pages4
JournalAmerican journal of obstetrics and gynecology
Issue number3
Early online date14 Jun 2015
Publication statusPublished - Sep 2015


  • Birth Weight
  • Female
  • Fetal Development
  • Fetal Growth Retardation
  • Fetal Nutrition Disorders
  • Gestational Age
  • Growth Charts
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Male
  • Pregnancy
  • Reference Values
  • Journal Article
  • Research Support, Non-U.S. Gov't


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