medigraphic.com

2012, Number 2

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2012; 50 (2)

Risk factors associated with intrauterine growth restriction in newborns attended in a university hospital

Zepeda-Monreal J, Rodríguez-Balderrama I, Ochoa-Correa EC, de la O-Cavazos ME, Ambriz-López R

Language: Spanish
References: 49
Page: 173-181
PDF size: 98.20 Kb.


ABSTRACT

Background: intrauterine growth restriction (IUGR) is related with neonatal morbidity and mortality. The detection and prenatal monitoring are necessary for an early intervention. The objective was to establish the prevalence and risk factors associated with intrauterine growth restriction in the university hospital Dr. José Eleuterio González.
Methods: we performed an observational, cross-sectional study, during the period from May 2009 to April 2010. The sample was divided into two groups, asymmetrical and symmetrical IUGR.
Results: the global prevalence of IUGR was 13.5 %. We included 464 patients, 324 (70 %) with asymmetric IUGR and 140 (30 %) with symmetric IUGR. The maternal variables were not statistically significant (p = ns) between groups. We found a mean weight at birth higher (2548 ± 437.33) in the symmetric IUGR group (p ‹ 0.01), as well as a higher vaginal delivery rate (p ‹ 0.05) as compared with the asymmetrical IUGR group. The overall mortality rate was higher in the asymmetric IUGR group (p ‹ 0.01).
Conclusions: prevalence of IUGR in our population is higher than that reported in the literature; there were more preterm infants and higher mortality in the asymmetric group.


REFERENCES

  1. Arulkumaran S, Symonds IM, Fowlie A. Oxford handbook of obstetrics and gynaecology. Second edition. Oxford: University Press; 2004, p. 258.

  2. Goldenberg RL, Culhane JF. Low birth weight in the United States. Am J Clin Nutr 2007;85(2):584S-590S. Disponible en http://www.ajcn.org/content/85/2/584S.long

  3. World Health Organization. Physical status: the use and interpretation of anthropometry. Geneva: WHO; 1995.

  4. Baschat AA. Fetal responses to placental insufficiency: an update. BJOG 2004;111810):1031-1041.

  5. UNICEF. [Sitio web]. Panorama: México-Estadísticas. UNICEF; 2010. [Actualizado el 2 de marzo de 2010; consultado el 14 de agosto de 2010]. Disponible en http://www. unicef.org/spanish/infobycountry/mexico_statistics.html

  6. Bauer R, Walter B, Brust P, Füchtner F, Zwiener U. Impact of asymmetric intrauterine growth restriction on organ function in newborn piglets. Eur J Obstet Gynecol Reprod Biol 2003; 110(Supl 1):S40-S49.

  7. Sankaran S, Kyle PM. Aetiology and pathogenesis of IUGR. Best Pract Res Clin Obstet Gynaecol 2009;23(6):765-777.

  8. Halliday HL. Neonatal management and long-term sequelae. Best Pract Res Clin Obstet Gynaecol 2009;23 (6):871-880.

  9. Kliegman RM. Intrauterine growth retardation. En: Fanaroff AA, Martin RJ, editores. Neonatal-perinatal medicine. Sixth edition. St Louis: Mosby; 1997. p. 140-240.

  10. Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A. Morbidity and mortality among very-low- birth-weight neonates with intrauterine growth restriction. Am J Obstet Gynecol 2000;182(1 Pt 1):198-206.

  11. Hack M, Breslau N, Weissman B, Aram D, Klein N, Borawski E. Effect of very low birth weight and subnormal head size on cognitive abilities at school age. N Engl J Med 1991;325(4):231-237. Disponible en http://www. nejm.org/doi/pdf/10.1056/NEJM199107253250403

  12. Walker DM, Marlow N. Neurocognitive outcome following fetal growth restriction. Arch Dis Child Fetal Neonatal Ed 2008;93(4): F322-325.

  13. Berg AT. Indices of fetal growth retardation, perinatal hypoxiarelated factors and childhood neurological morbidity. Early Hum Dev 1989;19(4):271-83.

  14. Goldenberg RL. Factors influencing perinatal outcomes. Ann N Y Acad Sci 2004;1038:227-234.

  15. Sciarra JJ. Reproductive health: a global perspective. Am J Obstet Gynecol 1993;168(6 Pt 1):1649-1654.

  16. Neerhof MG. Causes of intrauterine growth restriction. Clin Perinatol 1995;22(2):375-385.

  17. Ross MG, Beall MH. Adult sequelae of Intrauterine growth restriction. Semin Perinatol 2008;32(3):213-218. Disponible en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527863/ ?tool=pubmed

  18. Fenton TR. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatr 2003;3:1-10. Disponible en http:// www.ncbi.nlm.nih.gov/pmc/articles/PMC324406/?tool= pubmed

  19. Ananth CV, Vintzileos AM. Distinguishing pathological from constitutional small for gestational age births in population- based studies. Early Hum Dev 2009;85(10):653- 658.

  20. Walker DM, Marlow N. Neurocognitive outcome following fetal grow restriction. Arch Dis Child Fetal Neonatal Ed 2008;93(4):F322-325.

  21. Hay WW et al. Intrauterine growth restriction. Neo Reviews 2001;2:129-138.

  22. Barker DJ, Glukman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS. Fetal nutrition and cardiovascular disease in adult life. Lancet 1993;341(8850):938-941.

  23. Cunningham FG. Williams obstetrics. 20th edition. New York: McGraw-Hill Publishers; 1997. p. 852.

  24. Tapia-Garza A, Valenzuela GL, Rodríguez BI. Madre adolescente como factor de riesgo de morbilidad y mortalidad neonatal en unidades de cuidados intensivos neonatales. Experiencia en un hospital universitario. Medicina Universitaria 2006;8(30):5-10.

  25. Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull WHO 1987;65 (5):663-737. Disponible en http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC2491072/?tool=pubmed

  26. Vélez MP. Prevalencia de bajo peso al nacer y factores maternos asociados: unidad de atención y protección materno- infantil de la clínica universitaria bolivariana, Medellín, Colombia. RCOG 2006;57(4):264-270.

  27. Odendaal HJ, Steyn DW, Elliott A, Burd L. Combined effects of cigarette smoking and alcohol consumption on perinatal outcome. Gynecol Obstet Invest 2009;67(1):1-8.

  28. Kramer MS. Socioeconomic determinants of intrauterine growth retardation. Eur J Clin Nutr 1998;52(Supl 1):S32-33.

  29. Kramer MS, Séguin L, Lydon J, Goulet L. Socioeconomic disparities in pregnancy outcome: why do the poor far so poorly? Pediatr Perinat Epidemiol 2000;14(3):194-210.

  30. Merkatz IR, Thompson JE. New perspectives on prenatal care. New York: Elsevier; 1990. p. 461.

  31. Kramer MS. Intrauterine growth and gestational duration determinants. Pediatrics 1987;80(4):502-511.

  32. de Jong CL, Gardosi J, Dekker GA, Colenbrander GJ, van Geijn HP. Application of a customised birthweight standard in the assessment of perinatal outcome in a high risk population. Br J Obstet Gynaecol 1998;105(5):531-535.

  33. Turan S, Miller J, Baschat AA. Integrated testing and management in fetal growth restriction. Semin Perinatol 2008; 32(3):194-200.

  34. Yoshida S, Unno N, Kagawa H, Shinozuka N, Kozuma S, Taketani Y. Pre-natal detection of a high-risk group for intrauterine growth restriction based on sonographic fetal biometry. Int J Gynecol Obst 2000;68(3):225-232.

  35. Holtrop PC. The frequency of hypoglycemia in full-term large and small of gestational age newborns. Am J Perinatol 1993;10(2):150-154.

  36. Gordon BA, Mhairi GM, Mary MK, Martha DM. Intrauterine growth restriction and the small-for-gestational-age infant. En: Gordon BA, editor. Avery. Avery’s neonatology: pathophysiology & management of the newborn. Sixth edition Philadelphia, USA: Lippincott Williams & Wilkins; 2005: 492-523.

  37. Yu V, Upadhyay A. Neonatal management of growthrestricted infant. Semin Fetal Neonatal Med 2004;9(5): 403-409.

  38. Godoy TG. Restricción de crecimiento intrauterino. Causas, características clínicas, y evaluación de factores asociados con policitemia sintomática. Pediatr 2008;35(2): 77-87.

  39. Tyson J, Kennedy K, Bruyles S, Rosenfeld R. The small for gestational age infant: accelerated or delayed pulmonary maduration? Increased or decreased survival? Pediatrics 1995;95(4):534-538.

  40. Ferguson S. Prolonged impairment of cellular immunity in children with intrauterine growth retardation. J Pediatr 1978;93(1): 52-56.

  41. Baschat AA. Fetal growth disorders. En: James DK, Steer PJ, Weiner CP, editores. High risk pregnancy management options. Third edition. Pennsylvania: Saunders Elsevier; 2006. p. 240-271.

  42. Lumley J, Watson L, Watson M, Bower C. Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. Cochrane Database Syst Rev 2001; (3):CD001056.

  43. Weiner CP. Pathogenesis, evaluation, and potential treatments for severe, early onset growth retardation. Semin Perinatol 1989;13(4):320-327.

  44. Bernstein I, Gabbe SG. Intrauterine growth restriction. En: Gabbe SG, Niebyl JR, Simpson JL, editores. Obstetrics: normal and problem pregnancies. Third edition. New York: Churchill Livingstone; 1996. p. 863-886.

  45. Kamoji VM, Dorling JS, Field DJ, Manktelow BN, Draper ES, Field DJ. Extremely growth-retarded infants: is there a viability centile? Pediatrics 2006;118(2):758-763.

  46. Piper J, Xenakis E, McFarland M, Elliott B, Berkus MD, Langer O. Do growth-retarded premature infants have different rates of perinatal morbidity and mortality than appropiately grown premature infants? Obstet Gynecol 1996;87(2):169-174.

  47. Baschat AA, Cosmi E, Bilardo CM, Wolf H, Berg C, Rigano S, et al. Predictors of neonatal outcome in early-onset placental dysfunction. Obstet Gynecol 2007;109(2 Pt 1):253-261.

  48. Westood M, Kramer MS, Munz D, Lovett JM, Watters GV. Growth and development of full-term nonasphyxiated smallfor- gestational-age newborns: follow-up thorugh adolescence. Pediatrics 1983;71(3):376-382.

  49. Barker DJ, Eriksson JG, Forsen T, Osmond C. Fetal origins of adult disease: strength of effects and biological basis. Int J Epidemiol 2002;31(6):1235-1239.




2020     |     www.medigraphic.com