Maternal Risk Factors and Imaging findings in Intrauterine Growth Restriction

Background: Intrauterine growth restricted (IUGR) fetuses are at higher risk of developing neonatal complications and also known to develop metabolic syndrome in adult life. So, an early antenatal detection, choosing the optimal time and method of delivery and intervention when required could minimize the risk significantly. Objective: To find out the prenatal outcome and the maternal and placental risk factors. Methods: A prospective study was conducted from January 2010 to January 2019, at a Teaching Hospital. A singleton pregnancy, above 28 weeks of gestation with clinical diagnosis of IUGR and confirmed by ultrasonography were included in the study. The statistical analysis was performed by Statistical Package of Social Sciences (SPSS) 23.0 software. Results: Maternal risk factors like low pregnancy body mass index, preeclampsia, anaemia, hypothyroidism and placental factors like retro placental hemorrhage were mainly responsible for intrauterine growth restriction. Conclusions: The early identification of risk factors and management of the same antenatal is an important issue to prevent adverse prenatal outcomes associated with IUGR.

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Maternal History and Uterine Artery Doppler in the Assessment of Risk for Development of Early- and Late-Onset Preeclampsia and Intrauterine Growth Restriction

Obstetrics and Gynecology International ◽

10.1155/2009/275613 ◽

2009 ◽

Vol 2009 ◽

pp. 1-6 ◽

Cited By ~ 35

Author(s):

Elisa Llurba ◽

Elena Carreras ◽

Eduard Gratacós ◽

Miquel Juan ◽

Judith Astor ◽

...

Keyword(s):

Risk Factors ◽

Early Onset ◽

Intrauterine Growth Restriction ◽

Uterine Artery ◽

Late Onset ◽

Maternal Risk Factors ◽

Maternal History ◽

Uterine Artery Doppler ◽

Maternal Risk ◽

Intrauterine Growth

Objective. To examine the value of one-step uterine artery Doppler at 20 weeks of gestation in the prediction pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR).Methods. A prospective multicentre study that included all women with singleton pregnancies at 19–22 weeks of gestation (w). The mean pulsatility index (mPI) of both uterine arteries was calculated. Receiver-operating characteristics curves (ROC) were drawn to compare uterine artery Doppler and maternal risk factors for the prediction of early-onset PE and/or IUGR (before 32 w) and late-onset PE and/or IUGR.Results. 6,586 women were included in the study. Complete outcome data was recorded for 6,035 of these women (91.6%). PE developed in 75 (1.2%) and IUGR in 69 (1.1%) cases. Uterine Doppler mPI was 0.99 and the 90th centile was 1.40. For 10% false-positive rate, uterine Doppler mPI identified 70.6% of pregnancies that subsequently developed early-onset PE and 73.3% of pregnancies that developed early-onset IUGR. The test had a lower detection rate for the late-onset forms of the disease (23.5% for PE and 30% for IUGR). Maternal history has a low sensitivity in the detection of early-onset cases, although it is better at detecting late-onset PE.Conclusion. Uterine artery Doppler and maternal risk factors seem to select two different populations - early and late-onset PE which might suggest a different pathogenesis.

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Maternal socio-demographic determinants and fetal outcome of intrauterine growth restriction

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183805 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3843

Author(s):

Arpita Singh ◽

Ambujam K.

Keyword(s):

Risk Factors ◽

High Risk ◽

Intrauterine Growth Restriction ◽

Growth Restriction ◽

Maternal Risk ◽

Intrauterine Growth ◽

Factors Associated ◽

Increased Risk ◽

Uterine Growth ◽

Intra Uterine Growth Restriction

Background: Intrauterine Growth Restriction is a major neonatal health issue. It is associated with increased risk of perinatal morbidity and mortality. Maternal factors are the major contributing factors of IUGR and studying these factors can help in preventing IUGR and reducing perinatal mortality. The objective is to study the maternal sociodemographic risk factors associated with Intra uterine growth restriction.Methods: This is a Case-control study conducted in the Department of Obstetrics and Gynaecology, GMC Thrissur. 115 cases of Intra Uterine Growth Restriction were compared to 115 controls. Data was collected by interviewing the mother using structured questionnaire which is pretested and by persual of antenatal records. Intra Uterine Growth Restriction is defined as occurring if the sonographic estimated fetal weight <10th percentile for that gestational age. Chi Square test was used for the analysis of data.Results: Low socio-economic status and malnutrition (BMI<18.5) were significant socio-demographic factors associated with fetal growth restriction. Mean birth weight in IUGR group was 1.8kg compared to 2.9kg in control group. Female fetuses were more commonly associated with IUGR. Intra Uterine Growth Restricted babies had lower Apgar scores (<7) and had more chances for NICU admission.Conclusions: By studying the maternal risk factors associated with Intra Uterine Growth Restriction, we could identify the high-risk group. Early predictive studies could be done in these high-risk pregnancies with focus on good antenatal care to reduce the problem of IUGR in the community.

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Factores de riesgo asociados a retraso del crecimiento intrauterino

South Florida Journal of Development ◽

10.46932/sfjdv2n5-012 ◽

2021 ◽

Vol 2 (5) ◽

pp. 6423-6440

Author(s):

Ricardo Salas Flores ◽

Brian González Pérez ◽

Verónica Olvera Mendoza ◽

Raúl de León Escobedo ◽

Hebert Huerta Martínez ◽

...

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Intrauterine Growth Restriction ◽

Growth Restriction ◽

Maternal Risk ◽

Intrauterine Growth ◽

Linear Association ◽

Factores De Riesgo ◽

Clinical Records ◽

Hospital General

INTRODUCCION: El crecimiento de un feto se considera restringido si el peso es dos desviaciones estándar menor que el de la media correspondiente a su edad gestacional, está por debajo del percentil 3 para su misma edad gestacional, o se estanca, es decir, no alcanza el tamaño que le corresponde por su potencial biológico. OBJETIVO: Identificar los factores de riesgo asociados con la restricción del crecimiento intrauterino en recién nacidos vivos. METODOS: Estudio observacional, descriptivo, transversal y retrospectivo. Se revisaron los expedientes clínicos de madres cuyo producto haya nacido vivo con un peso igual o menor a 2500 gramos en el periodo comprendido de Enero del 2012 a Diciembre del 2013, en el Hospital General Regional N° 6 (HGR#6) del IMSS. El análisis de los datos obtenidos se llevó a cabo mediante regresión lineal, estadística descriptiva y mediante medidas de tendencia central, para variables continuas, variables categóricas, porcentajes y frecuencias. RESULTADOS: El análisis estadístico realizado demostró una asociación lineal significativamente fuerte de 94 % entre las anormalidades placentarias y el RCIU (p=0.000) IC 95%, DE 127.9-425.0. Así mismo existe asociación lineal moderada entre la Hipertensión arterial crónica y RCIU en un 47% (p= 0.013) IC 95% DE 25.9-205.5 CONCLUSIONES: Los factores de riesgo maternos son los que se asocian con mayor frecuencia a RCIU en recién nacidos vivos del HGR #6 del IMSS. INTRODUCTION: The growth of a fetus is considered restricted if the weight is two standard deviations less than that of the mean corresponding to its gestational age, is below the 3rd percentile for the same gestational age, or is stagnant, that is, it does not reach the size that corresponds to it due to its biological potential. OBJECTIVE: To identify the risk factors associated with intrauterine growth restriction in live newborns. METHODS: Observational, descriptive, cross-sectional and retrospective study. The clinical records of mothers whose product was born alive with a weight equal to or less than 2500 grams in the period from January 2012 to December 2013 were reviewed at the Hospital General Regional N ° 6 (HGR # 6) of the IMSS. The analysis of the data obtained was carried out using linear regression, descriptive statistics and measures of central tendency, for continuous variables, categorical variables, percentages and frequencies. RESULTS: The statistical analysis performed showed a strong significant linear association of 94% between placental abnormalities and intrauterine growth restriction (IUGR) (p = 0.000) 95% CI, SD 127.9-425.0. Likewise, there is a moderate linear association between chronic arterial hypertension and IUGR in 47% (p = 0.013) 95% CI SD 25.9-205.5 CONCLUSIONS: Maternal risk factors are those most frequently associated with IUGR in live newborns from HGR # 6 of the IMSS.

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Maternal and Placental Risk Factors associated with Intrauterine Growth Restriction and the Perinatal Outcomes

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1351 ◽

2015 ◽

Vol 7 (3) ◽

pp. 176-181 ◽

Cited By ~ 1

Author(s):

Valsa CA Thekkedathu

Keyword(s):

Risk Factors ◽

Statistical Analysis ◽

Intrauterine Growth Restriction ◽

Perinatal Outcomes ◽

Growth Restriction ◽

Chronic Hypertension ◽

Maternal Risk ◽

Intrauterine Growth ◽

Factors Associated ◽

The Impact

ABSTRACT Objectives Identifying the factors responsible for the intrauterine growth restriction (IUGR) is very important, so that early interventions could be suggested to improve the perinatal outcome. The major objectives of this study are to analyze the impact of risk factors, specifically the maternal and placental risk factors, on IUGR and the perinatal outcomes. Materials and methods A prospective study was done on 60 women with IUGR pregnancies from January 2013 to January 2014, at Pushpagiri Medical College Hospital, Thiruvalla. Inclusion criteria were: singleton pregnancies, above the gestational age of 28 weeks, clinically diagnosed IUGR and confirmed subsequently on ultrasound. The statistical analysis was performed utilizing Statistical Package of the Social Sciences (SPSS) software and the significance level of p-value < 0.05 was accepted as statistically significant. Results Statistical analysis shows that maternal risk factors like chronic hypertension, pre-eclampsia, low socioeconomic status of mother, overt diabetes, anemia, gestational diabetes mellitus, low prepregnancy body mass index and hypothyroidism were significantly associated with IUGR. In this study, placental factors like chorangiomatosis, increased syncytial knotting, villous infarction, increased perivillous fibrinoid deposition, accelerated villous maturation, retroplacental hemorrhage and acute chorioamnionitis were significantly associated with IUGR. Conclusion Alertness toward antenatal risk factors for poor pregnancy outcome is important for the optimal management of IUGR pregnancies. Despite antenatal recognition of IUGR and associated risk factors, not all perinatal deaths can be prevented. How to cite this article Thekkedathu VCA. Maternal and Placental Risk Factors associated with Intrauterine Growth Restriction and the Perinatal Outcomes. J South Asian Feder Obst Gynae 2015;7(3):176-181.

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Analysis of frequency and risk factors for intrauterine growth restriction

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20175936 ◽

2017 ◽

Vol 4 (1) ◽

pp. 11

Author(s):

Abha Shrestha

Keyword(s):

Risk Factors ◽

Intrauterine Growth Restriction ◽

Perinatal Outcome ◽

Neonatal Intensive Care ◽

Adult Life ◽

Growth Restriction ◽

University Hospital ◽

Singleton Pregnancy ◽

Maternal Risk ◽

Intrauterine Growth

Background: Intrauterine growth restricted (IUGR) fetuses are at greater risk of developing fetal hypoxia, neonatal complications, impaired neurodevelopment, and also neonatal intensive care unit stay and neonatal mortality. They are also known to develop metabolic syndrome in adult life. So, the main objective of this study was to find out the frequency of intrauterine growth restriction, to identify the maternal and placental risk factors associated with intrauterine growth restriction and its perinatal outcome amongst pregnant women attending the Obstetric Outpatient Department in Dhulikhel Hospital, Kathmandu University Hospital.Methods: A prospective study was conducted from June 2011 to June 2017, at Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal. A singleton pregnancy, above 28 weeks of gestation with clinical diagnosis of IUGR and confirmed by ultrasonography were included in the study. The statistical analysis was performed by Statistical Package of Social Sciences (SPSS) 20.0 software. Results: Maternal risk factors like preeclampsia, anaemia, low pregnancy body mass index and placental factors like retroplacental hemorrhage were mainly responsible for intrauterine growth restriction.Conclusions: Antenatal risk factors responsible for IUGR are important for the management of IUGR pregnancies and to prevent adverse perinatal outcome.

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Maternal risk factors and perinatal outcomes in fetal growth restriction using obstetric Doppler in South Kerala, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185062 ◽

2018 ◽

Vol 8 (1) ◽

pp. 6

Author(s):

Heera Shenoy T. ◽

Sonia X. James ◽

Sheela Shenoy T.

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Perinatal Outcomes ◽

Growth Restriction ◽

P Value ◽

Maternal Risk Factors ◽

Maternal Risk ◽

The Mean

Background: Fetal Growth Restriction (FGR) is the single largest contributing factor to perinatal morbidity in non-anomalous foetuses. Synonymous with Intrauterine Growth Restriction (IUGR), it is defined as an estimated fetal weight less than the10th percentile. Obstetric Doppler has helped in early detection and timely intervention in babies with FGR with significant improvements in perinatal outcomes. Hence, authors evaluated the maternal risk factors and diagnosis-delivery intervals and perinatal outcomes in FGR using Doppler.Methods: This research conducted in a tertiary care hospital in South Kerala included 82 pregnant women who gave birth to neonates with birth weight less than the 10th percentile over a period of1 year (Jan 1, 2017-Dec 31, 2017). Socio-demographic, maternal risk, Diagnosis- delivery interval in FGR and neonatal morbidities were studied.Results: Mean GA at diagnosis in weeks was 34.29 and 35.19 respectively for abnormal and normal Doppler respectively (p value-0.032). The mean birthweight in Doppler abnormal FGR was 272.34 g lesser than in Doppler normal group (p value-0.001). Growth restricted low birth weight neonates had Doppler pattern abnormalities (p value-0.0009). FGR <3rd percentile and AFI <5 had abnormal Doppler (OR:6.7). Abnormal biophysical profile (OR:14) and Non-Reactive NST (OR:3.5) correlated with abnormal Doppler. Growth restricted with normal Doppler had shorter NICU stays than with abnormalities (p value-0.003). Term FGR went home early than early preterm. (p value-0.001).Conclusions: Abnormal Doppler velocimetry is significantly associated with earlier FGR detection, shorter decision- delivery interval, reduction in the mean birthweight and longer NICU stay. Hence, Umbilical artery Doppler and Cerebroplacental index is an integral part of in-utero fetal surveillance to identify impending fetal hypoxia, appropriate management, optimising the timing of delivery and improve perinatal health in FGR.

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Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil

Revista de Saúde Pública ◽

10.1590/s0034-89102007000100006 ◽

2007 ◽

Vol 41 (1) ◽

pp. 35-43 ◽

Cited By ~ 16

Author(s):

Marcia Furquim de Almeida ◽

Gizelton Pereira Alencar ◽

Hillegonda Maria Dutilh Novaes ◽

Ivan França Jr ◽

Arnaldo Augusto Franco de Siqueira ◽

...

Keyword(s):

Risk Factors ◽

Prenatal Care ◽

Intrauterine Growth Restriction ◽

Population Based ◽

Sao Paulo ◽

Growth Restriction ◽

Fetal Mortality ◽

São Paulo ◽

Intrauterine Growth ◽

The City

OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.

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