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The impact of intrauterine growth restriction on respiratory outcomes

Bárbara Oliveira1, Filipa Flôr-DE-Lima2,3, Gustavo Rocha2,3

  • 1Faculty of Medicine, University of Porto, Porto, Portugal - bjoliveira93@gmail.com.

Minerva Pediatrics
|June 2, 2017
PubMed

Insights

Intrauterine growth restriction (IUGR) did not predict Bronchopulmonary Dysplasia (BDP) in premature infants. However, abnormal umbilical artery flow and sepsis were significant risk factors for BDP in these vulnerable newborns.

Area of Science:

  • Neonatal Medicine
  • Perinatology
  • Respiratory Medicine

Background:

  • Intrauterine growth restriction (IUGR) is defined as fetal growth below genetic potential.
  • IUGR is associated with increased respiratory morbidity and mortality in neonates.
  • Umbilical artery flow changes in IUGR fetuses are linked to adverse respiratory outcomes.

Purpose of the Study:

  • To investigate the impact of IUGR on respiratory outcomes in premature neonates (<32 weeks gestational age).
  • To identify risk factors for respiratory morbidity in preterm infants with IUGR.

Main Methods:

  • Retrospective cohort study of infants born <32 weeks gestational age (January 2010 - December 2016).
  • Matched 1:2 ratio of IUGR cases to appropriate birthweight controls based on gestational age, sex, and birth period.
  • Analysis of respiratory outcomes, specifically Bronchopulmonary Dysplasia (BDP).

Main Results:

  • IUGR was not a significant predictor of Bronchopulmonary Dysplasia (BDP) (OR 4.80, P=0.033).
  • Abnormal umbilical artery flow was significantly associated with BDP (OR 4.80, P=0.033).
  • Late onset sepsis was also significantly associated with BDP (OR 3.31, P=0.044).

Conclusions:

  • Abnormal umbilical artery flow is a critical risk marker for BDP development in high-risk pregnancies like IUGR.
  • The combined effects of IUGR, altered umbilical artery flow, and extreme prematurity on lung morbidity require further investigation.
  • Larger studies are needed to fully clarify the impact on lung morbidity in this population.
Abstract

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