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[Intrauterine growth retardation--perinatal mortality and postnatal morbidity in a perinatal center]
1Universitäts-Frauenklinik und Poliklinik mit Hebammenlehranstalt, Homburg/Saar.
Insights
Intrauterine growth retardation (IUGR) significantly increases risks for newborns, leading to high mortality and morbidity. Combined with prematurity, IUGR presents a critical high-risk scenario requiring specialized perinatal care.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Perinatal Medicine
- Fetal Medicine
Context:
- Intrauterine growth retardation (IUGR) is a major contributor to perinatal mortality and morbidity.
- Currently, effective treatments for IUGR are limited.
- The combination of prematurity and IUGR represents a significant high-risk obstetric scenario.
Purpose:
- To analyze perinatal data of infants diagnosed with IUGR.
- To assess mortality and morbidity rates in a cohort of IUGR infants.
- To describe the risks associated with prematurity and IUGR.
Summary:
- The study analyzed 220 IUGR infants, finding an IUGR incidence of 13.1% in premature and newborn populations.
- Perinatal mortality was 3.6%, with intrauterine fetal death observed in 1.4% of cases.
- Complications included deformities, chromosome aberrations, and significant rates of respiratory, cardiovascular, and cerebral issues, with 46.4% requiring Neonatal Intensive Care Unit transfer.
Impact:
- Infants with IUGR face elevated perinatal mortality and significant postnatal morbidity.
- Premature infants with IUGR are particularly vulnerable, necessitating close monitoring.
- Enhanced surveillance of pregnant women and newborns in perinatal centers is crucial for managing IUGR risks.
Objectives:
The intrauterine growth retardation (IUGR) contributes specially to perinatal mortality and morbidity. An effective treatment is not yet available. The purpose of this study is to analyse the perinatal data of a cohort with IUGR-infants including mortality and morbidity and to describe prematurity and IUGR as a combination of high risk.
Study Design:
We have analysed the perinatal data of a cohort of 220 patients with IUGR-infants including mortality and morbidity. Regularly we examined fetal ultrasonographic growth, doppler measurements of fetal and maternal vessels and CTG, as well as indicated amniocentesis, placentesis and cordocentesis. Entry criteria were: normal menstrual period before pregnancy, clear gestational age, complete history of pregnancy.
Results:
At the Department of Gynaecology & Obstetrics, University Hospital, Homburg/Saar, the incidence of IUGR (< 10th Percentile) in premature babies and newborns was 13.1% over five years (1993-1997). The percentage of premature babies with IUGR was 18.6%. The overall mortality was 4.1%, the perinatal mortality was 3.6% and the neonatal mortality was 2.7%. In 1.4% intrauterine foetal death was observed, all associated with a birthweight below the 3th percentile. The average duration of pregnancy was 34 + 4 weeks. A high perinatal mortality of 13.1% and an overall mortality of 14.7% was observed. 11.4% of the premature babies with IUGR showed deformities and about 2% presented chromosome aberrations. 46.4% of children have been transferred to the Neonatal Intensive Care Unit. 57.1% of the postnatal complications have been related to the lungs, 26.5% to the cardiovascular system and 14.3% to the cerebrum. Maternal complications were referred to: SIH/EPH-gestosis (65.4%), HELLP-syndrome (5.8%), nicotine abuse (31.4%), pregnancy anaemia (17.3%) and gestational diabetes with insuline therapy (7.7%). On the placental site the most noticeable conditions have been placental insufficiency (40.6%) and placental infarction (28.7%).
Conclusion:
Children with IUGR are exposed to high perinatal mortality and postnatal morbidity. Premature babies in association with an IUGR are at high risk. The surveillance of the pregnant women and the new-born children should be performed in a perinatal centre.