The frequency of pulmonary hypertension in newborn with intrauterine growth restriction
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Updated: Dec 21, 2025

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Published on: October 19, 2013
Ghulam Abbas1, Shahid Shah2, Muhammad Hanif3
1Department of Pharmaceutics, Faculty of Pharmaceutical Sciences Government College University Faisalabad, Faisalabad, Pakistan.
Insights
Intrauterine growth restriction (IUGR) in neonates is linked to a higher incidence of pulmonary hypertension (PH). Meconium aspiration syndrome (MAS) emerged as a significant contributing factor to PH in these infants.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Pulmonary Medicine
Background:
- Intrauterine growth restriction (IUGR) is a clinical condition in neonates characterized by malnutrition and impaired in-utero growth.
- Pulmonary hypertension (PH) is a serious complication that can affect neonates, particularly those with IUGR.
Purpose of the Study:
- To determine the frequency of pulmonary hypertension (PH) in neonates diagnosed with intrauterine growth restriction (IUGR).
- To investigate potential contributing factors to PH in IUGR neonates, including meconium aspiration syndrome (MAS), birth asphyxia (BA), and respiratory distress syndrome (RDS).
Main Methods:
- A descriptive cross-sectional study involving 96 neonates with IUGR and 38 neonates without IUGR.
- Data collection included gestational age (GA), birth weight (BW), weight percentile (WP), and the presence of MAS, BA, and RDS.
- Pulmonary arterial (PA) pressure was measured using echocardiography and Bernoulli's equation.
Main Results:
- 33.3% of IUGR neonates (32 out of 96) were diagnosed with PH.
- Meconium aspiration syndrome (MAS) showed a significant association with PH in IUGR neonates (p=0.0001).
- Higher percentages of IUGR neonates presented with birth asphyxia (34.4%), MAS (18.8%), and RDS (22.9%).
Conclusions:
- IUGR neonates have an increased likelihood of developing pulmonary hypertension (PH).
- Meconium aspiration syndrome (MAS) is a significant risk factor for PH in neonates with IUGR.
- Further research is warranted to explore the complex relationship between IUGR, MAS, and PH.
Abstract:
Intrauterine growth restriction (IUGR) is a clinical definition applied to neonates born with clinical features of malnutrition and in-utero growth retardation irrespective of their birth weight percentile. This study was aimed to determine the frequency of pulmonary hypertension (PH) in neonates with IUGR. In this descriptive cross-sectional study, we followed 96 neonates with IUGR (≤28 days) and 38 neonates without IUGR born in the department of the neonatal intensive care unit children hospital complex Multan, Pakistan. We analyzed certain factors such as gender, gestational age (GA) (weeks), birth weight (BW in kg), weight percentile (WP) for GA, meconium aspiration syndrome (MAS), birth asphyxia (BA) and respiratory distress syndrome (RDS) for pulmonary hypertension (PH) in IUGR and non-IUGR group. GA was measured by the Ballard scoring system. Echocardiography was performed for all patients by the pediatric cardiologist to measure pulmonary arterial (PA) pressure using Bernoulli's equation. Out of total 96 IUGR neonates, 33.3% (n = 32) suffered from PH, of which 65.3% (n = 18) were male and 43.7% (n = 14) were female. The percentages of IUGR neonates with BA, MAS and RDS were 34.4%, 18.8% and 22.9% respectively. The data were analyzed using the SPSS-16 software to test the statistical significance of the results. A p-value less than 0.05 was considered significant. When the chi-square test was applied, it depicted that MAS was significantly associated with PH in IUGR neonates (p = 0.0001) compared to non-IUGR neonates. Our findings suggested an increased chance of PH in IUGR neonates and MAS may be a strong factor.
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