Neonatal morbidity associated with disproportionate intrauterine growth retardation at term

Abstract

We set out to compare neonatal morbidity between disproportionate intrauterine growth retarded newborn infants and proportionate retarded ones at term, based on ponderal index. This is a prospective study of 185 single pregnancies with evidence of intrauterine growth retardation at term. Sixty three cases (34%) were disproportionate and 122 (66%) proportionate in terms of ponderal index. All were born in the University Hospital 'Principe de Asturias' of Alcala de Henares, Madrid, Spain. Proportionate or disproportionate intrauterine growth retardation diagnosis was established using the ponderal index (weight/length3). The following outcomes of neonatal morbidity were investigated: (1) perinatal asphyxia (meconium-stained amniotic fluid, abnormal fetal heart rates, newborn acidosis or low Apgar score 7 at 5 minutes) and/or (2) early neonatal medical complications. Disproportionate intrauterine growth retardated newborn infants presented higher rates of perinatal asphyxia (54% vs. 32%, P 0.01), with higher abnormal fetal heart rates (37% vs. 15%, P 0.01), higher frequency of arterial pH 7.20 (31% vs. 16%, P 0.05); and also higher rates of early neonatal medical complications (40% vs. 11%, P 0.001), mainly hypoglycaemia (25% vs. 4%, P 0.01). Morbidity among disproportionate intrauterine growth retardated Aconates is significantly higher compared with proportionate ones, demonstrating the heterogeneity of the intrauterine growth retardation population. Proportionate and disproportionate intrauterine growth retardation should be diagnosed as early as possible, since the majority of the morbidity is intimately related to this difference.