ASSESSMENT OF MATERNAL RISK FACTORS FOR INTRAUTERINE GROWTH RETARDATION (IUGR) AMONG NEWBORNS IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA: A CASE CONTROL STUDY.
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Keywords
intrauterine growth restriction, risk factor, hypertension, diabetes mellitus
Abstract
: Intrauterine growth retardation (IUGR) ranks as the second leading cause of perinatal illness and death. Several studies have identified multiple risk factors linked to IUGR. The present study aims to explore the maternal factors contributing to IUGR among term newborns in eastern India.
Methodology: A case-control study was conducted in a medical college in Kolkata with 64 subjects in each group. Data collected using a semi-structured questionnaire and maternal clinical records. Data analyzed using STATA MP/16 by appropriate statistical tests.
Results: Mothers of cases were older (27.9±5.58 years) compared to mothers of controls (26.4±5.19 years). There was significantly lesser weight gain during pregnancy among cases (7.01±2.13 Kg.) compared to (10.4±2.5 Kg) among controls (p<0.05). The mean maternal height of cases was also significantly lower than the controls. A significantly higher proportion of cases (p<0.05) had history of diabetes mellitus (15.6%), hypothyroidism (37.5%) and liquor abnormalities (22%) compared to controls (4.7%, 12.5% and 4.7% respectively). Univariate logistic regression analysis showed height of mother (OR: 0.86), weight gain during pregnancy (OR: 0.48), bad obstetrics history (OR:6.2), hypothyroidism (OR: 4.2) and liquor abnormalities (OR:5.6) were significantly associated with IUGR. In multivariable logistic regression factors like height of mother (AOR: 0.82), weight gain during pregnancy (AOR: 0.48) and liquor abnormalities (AOR: 29.5) retained their significance (p<0.05).
Conclusion: Screening of identified risk factors like maternal weight gain, hypothyroidism, liquor abnormalities, etc. and effective management of diabetes mellitus and pregnancy-induced hypertension (PIH) can contribute to decreasing the occurrence of IUGR in the population.
References
2. Kleijer ME, Dekker GA, Heard AR. Risk factors for intrauterine growth restriction in a socio-economically disadvantaged region. The Journal of Maternal-Fetal & Neonatal Medicine. 2005;18(1):23–30.
3. Radulescu L, Ferechide D, Popa F, Alfred R, Carol D. The importance of fetal gender in intrauterine growth restriction. J Med Life. 2013 Jan;6(1):38–9.
4. Murray E, M F, Fazel M, Kennedy S, Villar J, Stein A. Differential effect of intrauterine growth restriction on childhood neurodevelopment: a systematic review. British Journal of Obstetrics & Gynecology. 2015;122(8):1062–72.
5. Pallotto EK, Kilbride HW. Perinatal Outcome and Later Implications of Intrauterine Growth Restriction. Clin Obstet Gynecol [Internet]. 2006;49(2). Available from: https://journals.lww.com/clinicalobgyn/fulltext/2006/06000/perinatal_outcome_and_later_implications_of.8.aspx
6. Cruz-Lemini M, Crispi F, Valenzuela-Alcaraz B, Figueras F, Gómez O, Sitges M, et al. A fetal cardiovascular score to predict infant hypertension and arterial remodeling in intrauterine growth restriction. Am J Obstet Gynecol. 2014;210(6):552.e1-552.e22.
7. Arias F. Arias’ Practical Guide to High-Risk Pregnancy and Delivery: A South Asian Perspective. 3rd. Bhide A, Arulkumaran S, Damania KR, Daftary SN, editors. New Delhi: Elsevier; 2019. 5–34 p.
8. Petrou S, Sach T, Davidson L. The long-term costs of preterm birth and low birth weight: results of a systematic review. Child Care Health Dev. 2001;Mar 27(2):97–115.
9. De Onis M, Habicht JP. Anthropometric reference data for international use: Recommendations from a World Health Organization Expert Committee. American Journal of Clinical Nutrition. 1996;64(4):650–8.
10. Barker ED, McAuliffe FM, Alderdice F, Unterscheider J, Daly S, Geary MP, et al. The role of growth trajectories in classifying fetal growth restriction. Obstetrics and gynecology. 2013;122(2 Pt 1):248–54.
11. Bamfo JEAK, Odibo AO. Diagnosis and Management of Fetal Growth Restriction. J Pregnancy. 2011;2011(1).
12. Dapkekar PP, Kawthalkar AS, Valerao A V, Somalwar SA. Risk Factors Associated with Intrauterine Growth Restriction: A Scoping Review. Journal of Datta Meghe Institute of Medical Sciences University. 2023;18:130–4.
13. Surve R, Jain A. Risk factors associated with intrauterine growth restriction (IUGR) in neonates: A matched case -control study in Tertiary Care Hospital. Pravara Medical Review. 2019;11(3):33–43.
14. Manandhar T, Prashad B, Nath Pal M. Risk Factors for Intrauterine Growth Restriction and Its Neonatal Outcome. Gynecology & Obstetrics. 2018;08(02).
15. Mohammad N, Sohaila A, Rabbani U, Ahmed S, Ahmed S, Ali SR. Maternal predictors of intrauterine growth retardation. Journal of the College of Physicians and Surgeons Pakistan. 2018;28(9):681–5.
16. Shrestha A, Pradhan N, Kayastha B. Risk Factors for Intrauterine Growth Restriction: 9 Years Analysis in Tertiary Care Hospital. Journal of BP Koirala Institute of Health Sciences. 2019;2(1):77–82.
17. Odibo A, Nelson D, Stamilio D, Sehdev H, Macones G. Advanced maternal age is an independent risk factor for intrauterine growth restriction. Am J Perinatol. 2006;23:325–8.
18. Anjum F, Javed T, Afzal M, Sheikh G. Maternal risk factors associated with low birth weight: A case control study. ANNALS. 2011;17:223–8.
19. Muhammad T, Khattak A, Rehman S, Khan M, A K, Khan M. Maternal factors associated with intrauterine growth restriction. Ayub Med Coll Abbottabad. 2010;22:64–9.
20. Muthayya S. Maternal nutrition & low birth weight – what is really important? Review article. Indian J Med Res. 2009;130:600–8.
21. Abrams B, Selvin S. Maternal weight gain pattern and birth weight. Obstet Gynecol. 1995;86:163–9.
22. Muthayya S. Maternal vitamin B12 status is a determinant of intrauterine growth retardation in South Indians. Eur J Clin Nutr. 2006;60:791–801.
23. World Health Organization. Maternal anthropometry and pregnancy outcomes: a WHO collaborative study. Bull World Health Organ. 1995;73(Suppl):1–98.
24. Acharya D, Nagraj K, Nair S, Bhat H. Maternal Determinants of Intra Uterine Growth Retardation: A Case Control Study in Udupi District , Karnataka. Indian Journal of Community Medicine. 2004;29(4):10–2.
25. Motghare D, Vaz FS, Pawaskar A, Kulkarni M. Maternal determinants of intrauterine growth restriction in Goa, India: a case-control study. Global Journal of Medicine and Public Health. 2014;3(1).
26. Prada J, Tsang R. Biological mechanisms of environmentally induced causes of IUGR. Eur J Clin Nutr. 1998;52:21–7.
27. Burke N. Influence of maternal risk factors on perinatal outcomes in IUGR: analysis of the national multicenter prospective PORTO study. Am J Obstet Gynecol. 2014;210:93.
28. Thompson J. Risk factors for small-for-gestational-age babies: The Auckland birth weight collaborative study. Journal of Paediatric Child Health. 2001;37:369–75.
29. Aghamolaei I, Eftekhar H, Zare S. Risk factors associated with intrauterine growth retardation (IUGR) in Bandar Abbas. J Med Sci. 2007;7:655–9.
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Dr. Rohit Bannerji
Associate Professor, Pediatrics, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata. Email: [email protected], ORCID ID: https://orcid.org/0000-0001-6726-9838
Dr. Mahuya Lahiri
Associate Professor, Pediatrics, ESIC Medical College & Hospital, Beltola, Guwahati. Email: [email protected]; ORCID ID: https://orcid.org/0000-0001-6870-415X
Dr. Kalyan Kumar Paul
Associate Professor, Community Medicine, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata. Email: [email protected]; ORCID ID: https://orcid.org/0000-0002-5043-8284
Dr. Rajb Roy
Professor, Obstetrics & Gynecology, ESIC Medical College & Hospital, Bihta, Patna. Email: [email protected]; ORCID ID: https://orcid.org/0000-0001-7342-3336
