Several factors contribute to growth restriction. These include maternal health conditions such as pre-eclampsia, chronic hypertension, and diabetes. Lifestyle factors like smoking, alcohol consumption, and substance abuse can also play a role. Additionally, fetal factors such as genetic abnormalities and congenital infections (e.g., cytomegalovirus or toxoplasmosis) are critical contributors. Placental issues, including placental insufficiency and abnormal placental attachment, can further exacerbate the problem.