ABSTRACT
Background: Fetal growth is a complex process whichdepends on nutrient and oxygen availability and transport fromthe mother to the fetus across the placenta. This involveshormones and growth factors as well as maternal and fetalgenes. The failure of the fetus to reach his or her full potentialfor growth is called intrauterine growth restriction (IUGR) andimplies risk for adverse short- and long-term outcomes.Objective: To study the frequency, risk factors and outcome ofthe clinical management of IUGR infants in the NICU of atertiary care hospital.Methods: This case control study was conducted from August2015 to July 2016 in the department of Neonatology,Bangabandhu Sheikh Mujib Medical University (BSMMU). Priorapproval from Institutional Review Board (IRB) for this researchwork was taken.After taking consent from parents/Guardians, particulars of theneonates, antenatal, natal and postnatal history were recordedin a data collection form. All Newborn in the NICU during studyperiod were the study population. Newborn who meet theinclusion criteria were divided into two groups as case group(IUGR babies) and control group (AGA babies). The riskfactors were identified by taking face to face interview ofmother regarding prenatal period whereas the outcome ofclinical management was observed by the caution and carefulNICU follow up of the baby. Data were analyzed by statisticalpackage for social sciences (SPSS) version 20. At firstfrequency of IUGR was found among all admitted newborn.Risk factors were analyzed to calculate the odds ratio. Thenrisk factors were analyzed with chi square test to find outsignificant risk factors. P values less than 0.05 (95% CI) wereconsidered statistically significant.Results: The frequency of IUGR babies in this one year studywas found 11.86%. Congenital malformation (p=0.02) wasfound as significant fetal risk factor. Congenital CMV infectionwas found in 16.3 % case of IUGR babies. Maternal weight(p=<0.001), height (p=<0.001), socioeconomic status of mother(p=0.001), Inter pregnancy Interval (p=0.04), placentalinsufficiency (p=0.001), Pregnancy Induced hypertension(p=0.001) are significant maternal risk factor. Hypoglycemia(p=0.007) and hyperbilirubinemia (p=<0.001) were foundsignificant co-morbidities. Length of hospital stay wassignificantly higher among IUGR babies (p= 0.001) thatproclaim the outcome of clinical management. In case group16.3% and in control 8.2% babies expired even after providingall available standard clinical management. Most of thepatients died due to sepsis in both the groups. But the mortalityshowed no significant differences as outcome of clinicalmanagement.Conclusion: IUGR babies in BSMMU was 11.86%. Maternalweight, height, inter pregnancy interval, socioeconomic status,Pregnancy induced hypertension, placental insufficiency, lessANC visits were maternal risk factors for IUGR babies.