Which of the following increases the risk of IUGR?

Maternal hypertension is a significant risk factor for intrauterine growth restriction (IUGR) because it can lead to placental insufficiency. When blood flow to the placenta is compromised, the fetus receives less oxygen and nutrients than necessary for normal growth and development. Conditions such as preeclampsia, a type of hypertension in pregnancy, can further exacerbate this issue by increasing vascular resistance and potentially leading to placental abruption. This ultimately results in the fetus being small for gestational age and may be classified as growth restricted.

In contrast, fetal macrosomia refers to an excessively large fetus, typically associated with conditions such as maternal diabetes, and is not linked to IUGR, which involves fetuses being small. Multiparity may indicate a woman who has had multiple pregnancies, but it does not itself directly contribute to IUGR risk. Elective cesarean deliveries are a mode of delivery choice that, while they may have their own set of risks and benefits, does not inherently increase the risk of IUGR. Thus, maternal hypertension is clearly identified as a primary risk factor contributing to IUGR.