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Which type of growth restriction is generally associated with the poorest long-term prognosis?

  1. Symmetrical growth restriction

  2. Asymmetrical growth restriction

  3. Normal growth

  4. Overgrowth

The correct answer is: Symmetrical growth restriction

Symmetrical growth restriction is associated with the poorest long-term prognosis primarily because it indicates that the fetus is uniformly affected throughout its growth and development. This type of restriction often occurs due to intrinsic factors, such as genetic abnormalities or congenital infections, which can result in a more profound impact on the overall development of the fetus. In symmetrical growth restriction, both the size and the proportions of the fetus are reduced, which signifies that the growth impairment is likely occurring early in the gestation period, affecting overall organ development and function. As a result, these infants may face complications not only at birth but throughout their lives, including neurological deficits and other health issues. In contrast, asymmetrical growth restriction, which may result from placental insufficiency later in pregnancy, can sometimes allow for the preservation of brain growth relative to body size, leading to better neurodevelopmental outcomes. Normal growth indicates no issues, while overgrowth typically suggests conditions like gestational diabetes but does not involve the complications linked to growth restriction. Thus, the significant implications of symmetrical growth restriction on a developing fetus highlight its association with poorer long-term outcomes.