Fetal Growth Restriction

Publication Date: February 1, 2019
Last Updated: March 14, 2022

Recommendations and Conclusions

The following recommendations and conclusions are based on good and consistent scientific evidence.

  • Umbilical artery Doppler velocimetry used in conjunction with standard fetal surveillance, such as nonstress tests, or biophysical profiles, or both, is associated with improved outcomes in fetuses in which fetal growth restriction has been diagnosed.
  • Antenatal corticosteroids are recommended if delivery is anticipated before 33 6/7 weeks of gestation because they are associated with improved preterm neonatal outcomes. In addition, antenatal corticosteroids are recommended for women in whom delivery is anticipated between 34 0/7 and 36 6/7 weeks of gestation, who are at risk of preterm delivery within 7 days, and who have not received a previous course of antenatal corticosteroids.
  • For cases in which delivery occurs before 32 weeks of gestation, magnesium sulfate should be considered for fetal and neonatal neuroprotection.
  • Nutritional and dietary supplemental strategies for the prevention of fetal growth restriction are not effective and are not recommended.
( A )

The following recommendations and conclusions are based primarily on consensus and expert opinion.

  • Fetal growth restriction alone is not an indication for cesarean delivery.
  • The optimal timing of delivery of the growth-restricted fetus depends on the underlying etiology of the growth restriction (if known), the estimated gestational age, and other clinical findings such as antenatal fetal surveillance.

Recommendation Grading




Fetal Growth Restriction

Authoring Organization

Publication Month/Year

February 1, 2019

Last Updated Month/Year

January 9, 2023

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Female, Adolescent, Adult

Health Care Settings


Intended Users

Physician, nurse nurse midwife, nurse certified nurse midwife, nurse, nurse practitioner, physician assistant


Assessment and screening, Management

Diseases/Conditions (MeSH)

D048788 - Growth and Development, D005317 - Fetal Growth Retardation


intrauterine growth restriction, Fetal growth restriction, pregnancy complication