Fetal Growth Restriction Prevention: Is There a Role for Aspirin, Heparin, Statins, and Others?

Fetal Growth Restriction (FGR) affects up to 10% of pregnancies and is linked to perinatal morbidity and mortality. This review summarizes current and emerging therapies aimed at preventing and treating placental-mediated FGR. Low-dose aspirin initiated before 16 weeks shows the strongest evidence for benefit. Low-molecular-weight heparin and other interventions-including phosphodiesterase-5 inhibitors, statins, nitric oxide donors, VEGF gene therapy, melatonin, and IGF-based strategies-remain investigational. Given shared pathophysiology with preeclampsia, FGR presents an opportunity for early intervention. Future efforts must focus on risk stratification and development of targeted therapies to improve placental function and fetal outcomes.