What is the most common neonatal complication associated with fetal growth restriction (FGR)?

Hypoglycemia is indeed the most common neonatal complication associated with fetal growth restriction (FGR). FGR often results from underlying maternal conditions such as diabetes, hypertension, or placental insufficiency, which can lead to inadequate nutrient supply to the fetus. As a result, these infants are at a higher risk for metabolic issues, including low blood sugar levels at birth.

When a baby is born small for gestational age due to FGR, they may not have adequate glycogen stores to maintain normal blood glucose levels after birth, especially if the mother had conditions affecting insulin levels or fetal nutrient supply. This metabolic response is compounded by the lack of adequate stores to compensate for the rapid transition from a placental-dependent supply of glucose to independent feeding, leading to hypoglycemia.

Other complications like respiratory distress syndrome or birth asphyxia, while significant, are less common compared to hypoglycemia specifically in the context of FGR. These may arise due to prematurity or specific circumstances around delivery but are not as universally observed as hypoglycemia in the FGR population.